ENDOMETRIAL CARCINOMA (Robbins pp 1061)

General: Most common cancer of female genital tract, more common than cervical carcinoma.

Epidemiology/At risk individuals: peak incidence: 55-65 year old. At risk individuals: endogenous factors: 1) obesity, 2) diabetes, 3) hypertension, 4) infertility, 5) ovarian abnormalities (polycystic disease, ovarian cancer ≫ esp oestrogen secreting), exogenous factors: 1) unopposed oestrogen administration (i.e.: treatment of menopausal symptoms ≫ increased risk by 5X), Tamoxifen (antioestrogen used in Breast Ca ≫ 4X increased risk).

Clinical features / course: There are two clinical settings evident: 1) younger aged patients that are perimenopausal, 2) older age patients that are post-menopausal. Symptoms include: irregular vaginal bleeding, leucorrhea. The cancer can be divided into various stages, the more advanced the stage ≫ the poorer the prognosis.

Morphology: Macroscopically, the tumour can be locally polypoid or diffuse over entire endometrium. Microscopically: 85% are adenocarcinomas, proliferating glands with malignant epithelial cells, sometimes squamous metaplasia of epithelium present (adenocarcinoma with squamous metaplasia). Three grades of differentiation are evident (i.e.: mild, moderate, well).

Treatment: Hysterectomy + radiation.

Category: Pathology Notes