Cancer of the Female Reproductive Tract

Cancer of the endometrium is the most common cancer of the female reproductive tract. Women at risk should have biopsies taken regularly because endometrial cancer is not always detected by Pap (Papanicolaou) smear. Treatment consists of hysterectomy (removal of the uterus) (Fig. 15-9) and sometimes radiation therapy. A small percentage of cases occur after overgrowth (hyperplasia) of the endometrium. This tissue can be removed by dilation and curettage (D&C), in which the cervix is widened and the lining of the uterus is scraped with a curette.

Almost all patients with cancer of the cervix have been infected with human papilloma virus (HPV), a virus that causes genital warts. Incidence also is related to high sexual activity and other sexually transmitted viral infections, such as herpes.

In the 1940s and 1950s, the synthetic steroid DES (diethylstilbestrol) was given to prevent miscarriages. A small percentage of daughters born to women treated with this drug have shown an increased risk of developing cancer of the cervix and vagina. These women need to be examined regularly.

Cervical carcinoma is often preceded by abnormal growth (dysplasia) of the epithelial cells lining the cervix. Growth is graded as CIN I, II, or III, depending on the depth of tissue involved. CIN stands for cervical intraepithelial neoplasia. Diagnosis of cervical cancer is by a Pap smear, examination with a colposcope, and biopsy. In a cone biopsy (Fig. 15-10), a cone-shaped piece of tissue is removed from the lining of the cervix for study. Often in the procedure, all of the abnormal cells are removed as well.

Cancer of the ovary has a high mortality rate because it usually causes no early symptoms. Often by the time of diagnosis, the tumor has invaded the pelvis and abdomen. Removal of the ovaries (oophorectomy) and oviducts (salpingectomy) along with the uterus is required (see Fig. 15-9), in addition to chemotherapy and radiation therapy.

FIGURE 15-9. A hysterectomy is surgical removal of the uterus. Removal of the ovary (oophorectomy) and oviduct (salpingectomy) may also be required either unilaterally or bilaterally.
Cone Biopsy

FIGURE 15-10. Cone biopsy of the uterine cervix.

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  • Annabel
    What is a cone biopsy?
    3 years ago

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