Endometrial Carcinoma

Endometrial carcinoma: is a disease of older women (peak incidence is 55-65 years); about 80% of cases are found in women past the menopause and only 3% of cases occur in women under 40 years of age.

Risk factors: an increased incidence is associated with:

• Obesity

• Diabetes

• Hypertension

• Infertility

Most endometrial carcinomas follow on endometrial hyperplasia and can be related to the action of oestrogens.

[However there is also a group of well-differentiated tumours occurring in older women, which cannot be related to oestrogen and which have a worse prognosis.]

Morphology:

Grossly: endometrial carcinoma presents either as:

• A localized polyploidy tumour

• A diffuse spreading lesion involving the entire endometrial surface.

Histologically: most endometrial carcinomas are adenocarcinomas; biologically the:

• Less aggressive tumours include well differentiated carcinomas closely resembling normal endometrial glands (endometrioid), with squamous, secretory or mucinous differentiation.

• More aggressive neoplasms are poorly differentiated carcinomas, including clear cell carcinomas and papillary serous carcinomas.

Prognosis: depends on the state of the disease…

Category: Gynecology Notes