Endometrial adenocarcinoma

Endometrial adenocarcinoma 

Updated: 11/03/2023

© Jun Wang, MD, PhD

General features
  • Most common gynecologic malignancy in US
  • Incidence increasing
  • More common in postmenopausal women
  • Associated with complex endometrial hyperplasia, diabetes, dysfunctional uterine bleeding, hypertension, infertility, Muir-Torre syndrome, obesity, prolonged estrogen use, tamoxifen use
  • Endometrioid type most common, followed by serous type
  • May be part of Lynch Syndrome
Pathogenesis
  • Prolonged estrogenic stimulation with reduced progestational activity if endometrioid
Clinical presentations
  • Uterine bleeding
Classification
Molecular changes
Risk groups
  • Defined by stage, pathological features, etc
  • Low-risk: Grade 1 endometrial cancer of endometrioid histology that is confined to the endometrium. Very low recurrence following surgical treatment
  • Intermediate-risk:  Uterine-limited cancer with myometrium or occult cervical stromal involvement, higher risk of recurrence
  • High-risk: stage III or higher endometrial cancer, regardless of histology or grade; or any stage of serous carcinoma or clear cell carcinoma, high risk of relapse and death

Endometrioid vs serous/clear cell carcinoma

Treatment
  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Hormonal therapy


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