Endometrial Cancer

 

Commonest malignancy of the female genital tract in North America, accounting for 13% of all female cancers. It often presents early due to women's propensity to investigate abnormal bleeding.

 

 

 

Causes and Risk Factors

 

Endometrial cancer is the number one cancer caused by obesity due to aromatase andostrione from the adrenals to unapposed estrone. (CONFIRM THIS).

50 lbs is a 10x icreased risk

other risk factors include:

factors that decrease risk include:

 

 

 

Signs, Symptoms, and Diagnosis

 

 

  • history and physical exam
  • lab investigations
  • diagnostic imaging

History and Physical Exam

 

Per vaginal bleeding in pre-meas

Postmenopausal bleeding is cancer until proven otherwise.

Lab Investigations

Pap tests have a low sensitivty (~50%); endometrial biopsy is indicated.

D and C

aspiration biopsy: sensitivity ~90%

hysteroscopic biopsy

Diagnostic Imaging

Ultasound can be done to assess endometrial thickness.

 

 

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Pathophysiology

 

Various subtypes include:

endometroid: adenocarcinoma (+/- squamoid elements)

clear cell

uterine papillary serous

 

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Treatments

Medications

 

 

Surgery

Vaginal surgery and laparoscopy are options, with or without lympadenectomy.

Radiation and chemotherapy also important options.

 

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Consequences and Course

 

Survival depends on stage, rangin from ~75% for stage I and ~10% for stage IV.

 

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Resources and References