INVASIVE intraepitheilaial neoplasoa.pptx

this is the second most common cancer in women, it is preventable.

1. prof. maysoon sharief المرحلة الخامسة رقم المحاضرة: 39 جامعة البصرة/كلية الطب / فرع النسائية malignant disease of the cervix

2. Objectives 1- Define Ca Cx 2- To learn staging of the problem 3- To learn the methods of treatment 4- To learn the prognosis جامعة البصرة/ كلية الطب / فرع النسائية

3. histology 1- squamous carcinoma is 80-85% 2- adenocarcinoma is 15-20% جامعة البصرة /كلية الطب /فرع النسائية

4. Cervical cancer presentation Early stage :1- asymptomatically. 2-postcoital bleeding,postmenapausal bleeding, offensive blood-stained vaginal discharge. Late stage : backache, leg pain/oedema , haematuria , bowel changes, malaise, wt loss. جامعة البصرة /كلية الطب /فرع النسائية

5. Clinical presentation Incontinence due to vesicovaginal fistula , anaemia from chronic bleeding, renal failure from ureteric blockage. Examination : visualization of the cervix by spuculum there may be friable ,vascular mass or ulcer bleed on contact جامعة الصرة/كلية الطب / فرع النسائية

6. Diagnosis 1- History 2- cervical cytology 3- colposcopy + biopsy 4- U/S , 5- MRI, lymphoangiogram. جامعة البصرة /كلية الطب / فرع النسائية

7. Staging Staging include an assessment of disease extent and sites of spread by :- 1- clinical examination. 2- cystoscopy, sigmoidoscopy 3- CXR ,IVU 4- CT, MRI جامعة البصرة /كلية الطب / فرع النسائية

8. FIGO staging of cervical cancer(2009) 1 – stage 0 :carcinoma in situ. 2 - stage 1 : invasive carcinoma confined to the cx a- microinvasive. b- visible lesions. 3- stage 2 : cx carcinoma invades beyond the uterus ,but not to the pelvic wall or to the lower third of the vagina with parametrial invasion. جامعة البصرة/كلية الطب /فرع النسائية

9. Staging 4- stage 3 : the growth extends to the pelvic wall and/or involves the lower third of the vagina and/or causes hydronephrosis or non functioning kidney. 5- stage 4 : the carcinoma has extended beyond the pelvis. a- spread to adjacent organs . b- spread to distal organs. جامعة البصرة /كلية الطب / فرع النسائية

10. StatenIsland Universiaty Hospital

11. StatenIsland Universiaty Hospital

12. management 1- curative treatment 2- pallative treatment. جامعة الصرة /كلية الطب /فرع النسائية

13. management 1- stage 1 : a- microinvasive need simple hysterectomy. b- radical hysteractomy 2- stage 2 : radical hysterectomy + radiotherapy. 3- stage 3 ,4 : radiotherapy +chemotherapy

14. StatenIsland Universiaty Hospital

15. StatenIsland Universiaty Hospital

16. Complication of radiotherapy Bowel and bladder urgency, due inflammatory effects. Skin reythema-like burn. Vaginal stenosis in long term complication. Damage to ovaries , fistula formation. StatenIsland Universiaty Hospital

17. Pallative treatment 1- sedation for pain due to nerve infiltration. 2- Anemia correction. 3- Physiotherapy. 4- Urinary or bowel diversion. StatenIsland Universiaty Hospital

18. StatenIsland Universiaty Hospital

19. Quiz Which one of the following condition is true regard Ca Cx 1- Ti is common in nillparus women 2- Uterine involvement is regared as stage 11 3- The commenst presentation is columner epithelium 4- TI IS radiosensetive

20. StatenIsland Universiaty Hospital