Scribd
Upload
12 views9 pages

Endometrial Cancer Etiology and Pathology

Endometrial cancer is primarily caused by unopposed estrogen stimulation, with significant risk factors including age, obesity, and conditions like polycystic ovarian disease. Most cases are adenocarcinomas, often arising from endometrial hyperplasia, and can be influenced by genetic factors such as HNPCC mutations. Treatment with tamoxifen and unopposed estrogen replacement therapy also increases the risk of developing endometrial cancer.

Uploaded by

luckybanny811
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
12 views9 pages

Endometrial Cancer Etiology and Pathology

Endometrial cancer is primarily caused by unopposed estrogen stimulation, with significant risk factors including age, obesity, and conditions like polycystic ovarian disease. Most cases are adenocarcinomas, often arising from endometrial hyperplasia, and can be influenced by genetic factors such as HNPCC mutations. Treatment with tamoxifen and unopposed estrogen replacement therapy also increases the risk of developing endometrial cancer.

Uploaded by

luckybanny811
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Endometria

l
cancer
Etiolog
y
• Estrogen-persistent stimulation of endometrium with unopposed estrogen is
the single most important factor for the development of endometrial cancer.

• Age about 75% are postmenopausal with a median age of 60 , About 10% of
women with postmenopausal bleeding have endometrial cancer.

• Parity-it is quite common in unmarried and in married, nulliparity is associated


in about 30%

• Late menopause the chance of carcinoma increases, if menopause fails to


occur beyond 52 years

• corpus cancer syndrome encompasses obesity, hypertension, and diabetes


• Obesity leads to high level of free estradiol as the sex hormone binding globulin
level is low.

• Unopposed estrogen stimulation in conditions such as functioning ovarian


tumors (granulosa cell) is associated with increased risk of endometrial cancer.

• Unopposed estrogen replacement therapy in postmenopausal women is


associated with increased risk of endometrial cancer. Use of cyclic progestin
reduces the risk Prior use of combined oral contraceptives reduces the risk
significantly (50%).

• Polycystic ovarian disease increases the risk due to the persistent


hyperestrogenic state.

• fibroid is associated in about 30% cases


• Tamoxifen is antiestrogenic as well as weakly estro-genic.
> t is used for the treatment of breast cancer.
> Increased risk of endometrial cancer is noted when it is used for a long time
due
To It’s weak estrogenic effect.

• Family history: Hereditary nonpolyposis colorectal cancer (HNPCC) (AD


syndrome) is due to the mutations in mismatch repair genes (MLH1, MSH2).
> Mutation carriers have the risk of developing endometrial cancer (40-60%).
> BRCA1 and BRCA2 mutation carriers have a slight increased

• Endometrial hyperplasia precedes carcinoma in about 25% cases (Type 1).


Pathology
Naked Eye

• The uterus may be smaller, normal or even enlarged (due to myohyperplasia,


myometrial involvement, pyometra or associated fibroid).
Two varieties are found: Localized and
diffuse.
1. Localized: The usual site is on the
fundus. It is either sessile or
pedunculated. Myometrial
involvement is late.

2. Diffuse: The spread is through the


endometrium. The myometrium is
commonly invaded; may invade to
reach the serosal coat
Microscopic Appearances

The following varieties are noted:

• Adenocarcinoma (endometrioid (80%)]


• Adenocarcinoma with squamous elements
• Papillary serous carcinoma (5-10%) (virulent)
• Mucinous adenocarcinoma (1-2%)
• Clear cell adenocarcinoma (<5%)
• Secretory carcinoma (1%)
• Squamous cell carcinoma
• Mixed cell carcinoma
• Undifferentiated carcinoma (1-2%).
• most endometrial carcinomas are adenocarcinomas, commonly termed
endometrioid adenocarcinomas due to their resemblance with normal
endometrium.

• Depending upon the pattern of glands and individual cell changes

• these may be well-differentiated, moderately-differentiated or poorly-


differentiated.

You might also like