|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: Endometrial CAFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Fri Oct 11 15:08:52 2002
At Thu, 10 Oct 2002, Dr. Ainsworth wrote: > >88 yo woman with recent onset of bleeding, on no HRT. Small uterus on >TVUS with abnormally thickened endometrium. Biopsy showed well >differentiated adenoca of the endometrium. She has well-controlled >hypertension, dyslipidemia and angina. Also has Hx of bilateral >mastectomy 8 yrs ago for breast CA and no evidence of recurrence. Would >you: >1. TAH/BSO with nodes, etc. "the whole enchilada" 1-2 hours of >surgery, adequate staging. >2. TVH with BSO if possible. 30-45 minutes of surgery under spinal. >3. Megace. >4. Radiation. Prevent further growth and bleeding, temporize until she >dies. Start with trying vag hyst/bso, if not able then do TAH BSO. Pelvic and para aortic nodes are not that helpful for endometrial ca, the best indicator for need for radiotherapy to prevent local recurrence(not necessarily cure!) is depth of myometrial invasion. If patient is not obese the M&M of TAHBSO is not much greater than vag hyst for small uterus! "Why bother with surgery, she is too old and fragile." That’s the patient’s choice after you have done your best to explain the risks to her; begs the question why you did the endometrial biopsy in the first place.
--
Take care, John
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Dec 2 04:54:14 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.