Cancerous tumors in the uterine corpus are called endometrial cancers as 92% occur in the endometrium [1] and more than 80% of these are endometrial adenocarcinomas.

Although most endometrial cancers are diagnosed in the elderly with a median age of 65 years [2], it is also seen in younger women [3]. It presents commonly with abnormal uterine bleeding or spotting, dysuria (pain during urination), and dyspareunia. In 90% of endometrial cancer patients, uterine bleeding is the only symptom [4] and this cardinal presentation leads to an early diagnosis of the condition. Rarely, abnormal cervical cytology is the first clue to the presence of a uterine corpus malignancy in asymptomatic women. In perimenopausal women, the menstrual periods appear further apart and become scantier and so, any intermenstrual bleeding or heavy frequent menses should raise a cause for concern. In postmenopausal women, unprovoked vaginal bleeding may be the first symptom of endometrial adenocarcinoma.

Several risk factors have been reported to be associated with the development of endometrial adenocarcinoma and these are endometrial hyperplasia, obesity, hormonal treatment [5] [6], tamoxifen medication [7] [8], early menarche, late menopause or polycystic ovarian syndrome (PCOS) -conditions associated with prolonged unopposed estrogen effect, genetic predisposition [9] [10], hyperinsulinemia [11].

• Anemia

  Grade 3 TRAEs occurred in 16.7% and included asthenia and back pain; anemia, hyperglycemia, and hyponatremia; chills and pyrexia; diarrhea. There were no grade 4 or 5 events, and no immune-related adverse events were reported. [cancertherapyadvisor.com]

  In advanced stages, symptoms include intense pain, weight loss and anemia (low red blood cell count) Causes and Risk Factors The following factors may put a woman at higher risk of developing endometrial cancer: Being older than 40 years old (Less than [cedars-sinai.edu]

  Common side effects include: Dry, reddened skin in the treated area Fatigue Diarrhea Discomfort when urinating Narrowing of the vagina Anemia Most of these side effects are temporary. [foundationforwomenscancer.org]

  For example, your doctor may check it to see if you have anemia from a bleeding tumor. Also, high levels of some enzymes or other things made by cancer cells might mean canceer is likely. Imaging tests. [webmd.com]

• Abdominal Mass

  They commonly occur in elderly females presenting with vaginal bleeding, pain, weight loss, and abdominal mass. [4], [5] The unusual finding in our case was the absence of vaginal bleeding. [cancerjournal.net]

  Pelvic and abdominal CT are also done to check for extrauterine or metastatic cancer in patients with any of the following: An abdominal mass or hepatomegaly detected during physical examination Abnormal liver function test results A high-risk histologic [merckmanuals.com]

• Hypertension

  She had menopause at 51 year old hypertension history. [wjso.biomedcentral.com]

  Patients are frequently obese, diabetic, nulliparous, hypertensive, or have a late menopause. Most tumours are low-grade and have a favourable prognosis 1 Tavassoli FA, Devilee P (Eds.) World Health Organization Classification of Tumours. [codes.iarc.fr]

  It is not clear if this risk is due to the fact that many diabetics are also obese and hypertensive. [medical-dictionary.thefreedictionary.com]

  History of infertility 2–3 Nulliparity 3 Menstrual irregularities 1.5 Residency in North America or northern Europe 3–18 Higher level of education or income 1.5–2 White race 2 Older age 2–3 High cumulative doses of tamoxifen 3–7 History of diabetes, hypertension [accessmedicine.mhmedical.com]

  Because obesity and hypertension increase the risk of endometrial cancer and because evidence suggests that certain lifestyle choices may help prevent endometrial cancer, patients should be counseled about the importance of exercise, weight loss, and [merckmanuals.com]

• Vaginal Bleeding

  We present a case of vaginal hemorrhage because of endometrial adenocarcinoma after a supracervical hysterectomy in a patient using dabigatran. 74-year-old woman status after supracervical hysterectomy presented with profuse vaginal bleeding. [ncbi.nlm.nih.gov]

• Pelvic Pain

  In these cases, the patient usually complaints for pelvic or abdominal pain while the transvaginal ultrasonography might reveal the presence of an intrauterine fluid collection in association with a thickened endometrial lining. [ncbi.nlm.nih.gov]

  The symptoms of uterine cancer include Abnormal vaginal bleeding or discharge Trouble urinating Pelvic pain Pain during intercourse Uterine cancer usually happens after menopause. It is more common in women who have obesity. [medlineplus.gov]

  Other symptoms include unusual pelvic pain or pressure, difficult or painful urination, and pain during intercourse. [breastcancer.org]

  Many problems with the female reproductive tract can also include abnormal bleeding or pelvic pain. To start, doctors can perform a routine pelvic exam just like they do during a woman's annual physical. [study.com]

  […] during sexual intercourse; abdominal fullness/pressure; pelvic pain; pelvic mass; weight loss. [myriadmyrisk.com]

• Enlarged Uterus

  A physical or pelvic exam does not usually indicate much at all, although one’s doctor might feel a slight enlargement of the uterus. [thedoctorwillseeyounow.com]

  uterus that microscopically exhibits ectopic, non-neoplastic endometrial glands and stroma, surrounded by hypertrophic and hyperplastic myometrium ( 1 ). [ncbi.nlm.nih.gov]

  Rarely patients may present with an enlarged uterus or pelvic mass in the absence of bleeding. It should also be noted that 25% of patients with endometrial cancer are premenopausal and about 5% are under the age of 40. [clinicaladvisor.com]

• Dyspareunia

  It presents commonly with abnormal uterine bleeding or spotting, dysuria (pain during urination), and dyspareunia. [symptoma.com]

  […] ovarian cysts might experience any of the following symptoms: Menstrual irregularities or abnormal bleeding Dull ache in your lower back or thighs Pelvic pain shortly before or after the beginning of your menstrual cycle Pelvic pain with intercourse (dyspareunia [innovativegyn.com]

• Metrorrhagia

  This is a report on the coexistence of a uterine adenomatoid tumor and an endometrial adenocarcinoma, both chance findings in a 41-year-old woman undergoing hysterectomy because of a preoperative diagnosis of metrorrhagia due to leiomyomas. [ncbi.nlm.nih.gov]

  Symptoms and Signs Most ( > 90%) women with endometrial cancer have abnormal uterine bleeding (eg, postmenopausal bleeding, premenopausal recurrent metrorrhagia); one third of women with postmenopausal bleeding have endometrial cancer. [merckmanuals.com]

As endometrial adenocarcinomas can occur in peri as well as postmenopausal women, heavy menstrual bleeding or intermenstrual bleeding, irrespective of amount or duration, should be thoroughly investigated. It is important to elicit a detailed menstrual history, intake of contraceptive pills, hormonal therapy (for PCOS etc), hyperinsulinemia, and a family history of endometrial malignancy. Physical examination includes an examination of the pelvis, uterus, cervix and vagina as well as the inguinal region for lymphadenopathy. In most cases the uterine size is normal and no gross abnormalities are noticed.

Transvaginal ultrasonography is performed to detect abnormal endometrial thickening as it has good sensitivity [12] and this can be further confirmed with hydro ultrasonography i.e ultrasonography after injection of saline in the uterine cavity. If the abnormal endometrial thickness is detected, then routine laboratory studies, electrocardiogram and chest radiography should be obtained as part of the preoperative assessment. The patient is examined under anesthesia and an endometrial or hysteroscopic biopsy can be obtained for histopathological examination and final confirmation of endometrial adenocarcinoma. Further staging of the tumor may require a laparotomy to detect extrauterine spread and lymph node involvement.

Prognostic biomarkers like estrogen receptor (ER) and progesterone receptor (PR) are also tested as endometrial tumors associated with these markers are reported to have a good prognosis [13]. Immunohistochemistry to identify the absence of phosphatase and tensin homolog (PTEN) marker, a tumor suppressor, has also been reported as a sensitive method to predict cell proliferation and survival [14].

• Estrogen Increased

  Unopposed estrogen therapy, obesity, anovulatory cycles and estrogen-secreting neoplasms all increase the amount of unopposed estrogen and thereby increase the risk for endometrial cancer. [aafp.org]

  Hormone replacement therapy and estrogen: Either oral or body-produced estrogen increases the risk of this cancer. Environmental chemicals: Pesticides and air pollution have a direct effect on the risk of endometrial cancer. [vitamindcouncil.org]

There have been several reports about successful fertility-preserving treatment of endometrial carcinoma with subsequent pregnancy. However, conservative hormonal treatment for early-stage endometrial cancer still entails some risk. [ncbi.nlm.nih.gov]

Prognosis of Uterine Cancer (Adenocarcinoma of the Endometrium) Uterine cancer prognosis depends upon the type of tumor as well as the level of invasion. 75% are confined to the uterus at the time of diagnosis and are therefore more readily curable. 74% [healthengine.com.au]

Further investigations on larger sample size may provide additional data about prognosis of adenomyosis malignant transformation. [ncbi.nlm.nih.gov]

If limited to the polyp without stalk invasion, the prognosis is excellent. CERVICAL EXTENSION Involvement of the cervix has adverse effects on prognosis. [glowm.com]

PURPOSE: Endometrial cancer can be divided into two types: endometrioid Type 1 (G1, G2) has a hormonal driven etiology, while Type 2 is more aggressive (G3 endometrioid, clear cell and serous cancer type) and estrogen independent. [ncbi.nlm.nih.gov]

Brinton LA, Felix AS, McMeekin DS, Creasman WT, Sherman ME, Mutch D et al (2013) Etiologic heterogeneity in endometrial cancer: evidence from a Gynecologic Oncology Group trial. [link.springer.com]

[…] of the cases among other histologic types, type I includes mucinous and secretory carcinomas, whereas type II includes clear-cell carcinomas and adenosquamous carcinomas Embryonic origin tumour developped from the epithelium of the endometrial mucosa Etiology [atlasgeneticsoncology.org]

GYNECOLOGIC NEOPLASMS ENDOMETRIAL CANCER Etiology and Pathology Symptoms, Signs, and Diagnosis Staging, Prognosis, and Treatment OVARIAN CANCER Etiology and Pathology Symptoms, Signs, and Diagnosis Treatment CERVICAL CANCER Pathology Symptoms and Signs [health.am]

(Etiology) The exact cause and mechanism of formation of Endometrioid Carcinoma of Endometrium is unknown. [dovemed.com]

METHODS: We analyzed all women diagnosed with FIGO stage IIIC endometrial adenocarcinoma in the Surveillance, Epidemiology, and End Results database from 2004 to 2012 (n=2177). [ncbi.nlm.nih.gov]

The chapters are comprehensive and logically organized, covering the epidemiology and pathogenesis of endometrial adenocarcinoma, endometrial sampling techniques and the spectrum of cytomorphologic appearance from benign through hyperplasia to adenocarcinoma [karger.com]

We discuss the epidemiology, diagnosis, and treatment of endometrial cancer on the basis of a review of observational research, randomised trials, reviews, and meta-analyses. [bmj.com]

BMJ. 2011;343:d3954 Links: aetiology epidemiology pathology clinical features staging of endometrial cancer investigation diagnosis treatment prognosis recurrent endometrial cancer female genital tract cancers follow-up if history of endometrial cancer [gpnotebook.co.uk]

Recent association between first-trimester spontaneous abortions and subsequent endometrial cancer makes these rare cases of concurrent endometrial cancer and first trimester of pregnancy attractive in that they may disclose insights into the pathophysiology [ncbi.nlm.nih.gov]

The book emphasizes the correlation between clinical and pathologic features of female genital tract disease by examining the pathophysiology of individual organ systems. [books.google.ro]

Overview Historical Perspective Classification Pathophysiology Causes Differentiating Endometrial Cancer from other Diseases Epidemiology and Demographics Risk factors Screening Natural History, Complications and Prognosis Diagnosis Staging | History [wikidoc.org]

[…] post-menopausal woman with an intact uterus) tamoxifen treatment Hereditary Nonpolyposis Colon Cancer (HNPCC or Lynch Syndrome) on family history factors that decrease risk include: ovulation OCP progestin menopause normal weight multiparity smoking return to top Pathophysiology [sharinginhealth.ca]

"Role of nuclear progesterone receptor isoforms in uterine pathophysiology". Human Reproduction Update. 21 (2): 155–73. doi : 10.1093/humupd/dmu056. PMC 4366574. [en.wikipedia.org]

CONCLUSIONS Endometrial hyperplasia, especially complex endometrial hyperplasia with atypia, increase the risk for endometrial adenocarcinoma, and their early detection becomes mandatory under cancer prevention. [unboundmedicine.com]

Abstract Diethylstilbestrol (DES) was used widely in the late 1940s in an attempt to prevent adverse pregnancy outcomes. [ncbi.nlm.nih.gov]

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