LWBK1006-23 LWW-Govindan-Review December 12, 2011 19:10
Chapter 23•Gynecologic Cancers 323ANSWERS
Answer 23.2.1. The answer is A.
Type I endometrial cancers account for 80% of endometrial cancers. The
precursor lesion is atypical hyperplasia and these tumors are usually super-
ficial and low grade. Type I endometrial cancers have endometrioid his-
tology, and these cancers are related to prior estrogen exposure. They
demonstrate a large number of genetic changes, and appear to arise via a
progression pathway.Answer 23.2.2. The answer is C.
Type II endometrial cancers have serous or clear cell histology. Most
tumors are aggressive and progress rapidly. They are not associated with
estrogen exposure. The usual precursor lesion is endometrial intraepithe-
lial neoplasia.Answer 23.2.3. The answer is D.
Genetic changes that are characteristic of type I endometrial cancer
include KRAS, PTEN and-catenin mutations and MSI.Answer 23.2.4. The answer is A.
MSI is seen in type I endometrial cancers. Genetic changes characteristic
of type II endometrial cancers include p53 mutations and HER2/neu and
BCL2 amplification/overexpression.Answer 23.2.5. The answer is B.
Risk factors for endometrial cancer include increasing age, white race,
obesity, family history of endometrial cancer, prior pelvic radiation,
diabetes mellitus, gallbladder disease, estrogen replacement, estrogen-
producing tumors, early menarche and late menopause.Answer 23.2.6. The answer is D.
Infection with high-risk HPV appears to be the common cause for these
cancers.Answer 23.2.7. The answer is C.
Complete moles have a predominance of paternal chromosomes.Answer 23.2.8. The answer is C.
Cervical cancer is caused by exposure to high-risk strains of HPV. The
presence of HPV DNA has been identified in more than 99% of cer-
vical carcinomas. The epidemiologic information presented is correct.
The increased incidence of cervical cancer in Blacks and Hispanics in the
United States is thought to be secondary to barriers in screening because
of the lack of insurance, low income, and cultural differences.