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Tumors of Cervix. BENIGN –Adenoma –Myoma –Papilloma and angioma MALIGNANT Primary –Carcinoma – Sarcoma –Mesodermal mixed tumor Secondary –From any source.

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Presentation on theme: "Tumors of Cervix. BENIGN –Adenoma –Myoma –Papilloma and angioma MALIGNANT Primary –Carcinoma – Sarcoma –Mesodermal mixed tumor Secondary –From any source."— Presentation transcript:

1 Tumors of Cervix

2 BENIGN –Adenoma –Myoma –Papilloma and angioma MALIGNANT Primary –Carcinoma – Sarcoma –Mesodermal mixed tumor Secondary –From any source

3 Adenoma (Mucous Polyp) Clinical Features –Asymptomatic –Vaginal discharge –Vaginal bleeding –Mass at the introitus Differential Diagnosis –Carcinoma of the cervix –Cervical ectopy –Endometrial polyp –Products of conception and blood clot –Ectropion –Cervical tags

4 Adenoma (Mucous Polyp) Treatment –Asymptomatic must be removed and examined by the histopathologist –Adenoma may be avulsed easily without anaesthesia –Base of the polyp should be cauterized to avoid recurrence –Perform curettage

5 Myomas of Cervix Arise from body of uterus, rarely from cervix Polypoidal Protrude through cervical canal Types Subserous Intramural submucous

6 Myomas of Cervix Clinical Features –Prone to trauma –Ulceration –Infection –Vaginal discharge –Irregular vaginal bleeding –Mass at the introitus Treatment Vagival myomectomy or hysterectomy

7 Papilloma and Angioma Clinical features –Small papillomas –Single or multiple associated with vulva and vaginal papillomas –Angioma forms superficial growth Treatment –Surgical removal

8 Pre Malignant Conditions of Cervix

9 Cervical Intraepithelial Neoplasia (CIN) or Dysplasia Spectrum of disordered growth and abnormal microscopic changes confined to epithelium May be –Mild (CIN I) –Moderate (CIN II) –Severe or carcinoma in situ (CIN III) Spontaneous regression of mild and moderate types possible Severe dysplasia may be irreversible May progress into invasive carcinoma

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11 Cervical Intraepithelial Neoplasia (CIN) or Dysplasia CIN I (mild) Involves deeper 3rd of epithelium CIN II (moderate) Involves more than half thickness of epithelium CIN III (severe) Whole thickness of epithelium shows abnormal changes

12 Screening Screening programme Cervical smear Repeated every 3 y up to 60 y Normal cervix, transition zone

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17 anaplastic cancer cells show marked variation in size, in comparison with neutrophils Invasive carcinoma of cervix, Pap smear

18 Treatment Cryocautry Electrocuatry Surgery –Conization –LEEP –Hysterectomy Follow up

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22 Malignant Tumours of Cervix

23 Ca cervix One of the most common cancers in the world Incidence: USA 10/ UK 15/ Peak incidence at 35 and 55

24 Etiology Number of partners Age of first coitus Grand multi parity Social status Race and religion Circumcision Smoking Viruses herpes simplex type 2 / human papulama virus type 16 & 18 Atypical squamous metaplasia

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27 Pathology SQ cell carcinoma 90 % Adeno5% Mixed5% Gross Polypoidal Ulcerative Infiltrative

28 Squamous cell carcinoma cervix Tumour extends to anterior and posterior lips, appears granular and hemorrhagic, cervix surrounding by narrow vaginal cuff

29 lack of maturation, altered cell polarity, nuclear pleomorphism and increased nuclear / cytoplasmic ratio, confined to the epithelial layer, epithelial basement membrane not invaded, submucosal stroma contains chronic inflammatory cells Normal epithelium Squamous cell carcinoma in-situ of cervix

30 Spread Direct Lymphatic Blood born

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32 Diagnosis History Asymtpomatic Irregular vaginal bleedingIMB, PCB, PMB Pain Vaginal discharge Examination Normal cervix Hard cervix Ulcer Growth

33 Carcinoma Cervix

34 Diagnosis Cytology Schiller test Colposcopy Biopsy of cervix Punch biopsy Wedge biopsy Ring biopsy Cone biobsy

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36 Treatment Assessment Radiotheraphy Surgeryyoung, pelvic sepsis, UV prolapse, fibroid, ovarian tumor, recurrence, pregnancy Combined

37 Case History Age 36, mass at endocervical os which thickens the barrel of the cervix and fixes the cervix to the surrounding soft tissue Pap smear shows

38 Case History biopsy showed invasive nests of abnormal squamous epithelium extending under the surface mucosa, extending all the way through the cervical wall and out into the surrounding paracervical soft tissue

39 Case History The patient underwent a hysterectomy. The gross specimen shows thickened area representing the cervix. Tumour has extended through the wall. cervix was fixed to the soft tissues of the paracervical area

40 Thank You


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