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{{Endometrial cancer}}
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==Overview==
==Overview==
Endometrial cancer may be classified according to histology into either type I comprising 80% of endometrial cancers or type II accounting for around 20%.
==Classification==
==Classification==
Cellular Classification of Endometrial Cancer
Endometrial cancer may be classified according to histology into 2 types:<ref name="pmid6822361">{{cite journal| author=Bokhman JV| title=Two pathogenetic types of endometrial carcinoma. | journal=Gynecol Oncol | year= 1983 | volume= 15 | issue= 1 | pages= 10-7 | pmid=6822361 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6822361  }} </ref>
 
{| class="wikitable"
Endometrial cancers are classified in one of the following two categories:
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Type
 
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Histology
Type 1 may arise from complex atypical hyperplasia and is pathogenetically linked to unopposed estrogenic stimulation.
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Prognosis
Type 2 develops from atrophic endometrium and is not linked to hormonally driven pathogenesis.
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Pathogenesis
 
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Prevalence
Characteristic activating oncogenic mutations or amplification and inactivating mutations or deletion of tumor suppressors are seen more in association with one type of mutation versus the other type, but some overlap exists. With the Cancer Genome Atlas and a full genetic display of hundreds of endometrial cancers, four subtypes have been identified that will refine classification and provide prognostic and therapeutic implications.[1]
|-
 
| style="background:#DCDCDC;" align="center" + |Type I
The most common endometrial cancer cell type is endometrioid adenocarcinoma, which is composed of malignant glandular epithelial elements; an admixture of squamous metaplasia is not uncommon. Adenosquamous tumors contain malignant elements of both glandular and squamous epithelium;[2] clear cell and papillary serous carcinoma of the endometrium are tumors that are histologically similar to those noted in the ovary and the fallopian tube, and the prognosis is worse for these tumors.[3] Mucinous, squamous, and undifferentiated tumors are rarely encountered. Frequency of endometrial cancer cell types is as follows:
| style="background:#F5F5F5;" align="center" + |Endometroid (adenocarcinoma)
 
| style="background:#F5F5F5;" align="center" + |Favorable (estrogen-responsive)
Endometrioid (75%–80%).
| style="background:#F5F5F5;" align="left" + |• May arise from atypical hyperplasia <br> • Linked to unopposed estrogen stimulation
 
| style="background:#F5F5F5;" align="center" + |80%  
Ciliated adenocarcinoma.
|-
Secretory adenocarcinoma.
| style="background:#DCDCDC;" align="center" + |Type II
Papillary or villoglandular.
| style="background:#F5F5F5;" align="left" + |• Endometroid <br>• Serous <br>• Clear cell <br>• Mucinous <br>• Squamous <br>• Mesonephric <br>• Undifferentiated
Adenocarcinoma with squamous differentiation.
| style="background:#F5F5F5;" align="center" + |Typically bad prognosis
 
| style="background:#F5F5F5;" align="left" + |• Develops from atrophic endometrium <br>• Not linked to hormonally driven pathogenesis
Adenoacanthoma.
| style="background:#F5F5F5;" align="center" + |15-20%
Adenosquamous.
|}
 
Uterine papillary serous (<10%).
Mucinous (1%).
Clear cell (4%).
Squamous cell (<1%).
Mixed (10%).
Undifferentiated.Cellular Classification of Endometrial Cancer
 
Endometrial cancers are classified in one of the following two categories:
 
Type 1 may arise from complex atypical hyperplasia and is pathogenetically linked to unopposed estrogenic stimulation.
Type 2 develops from atrophic endometrium and is not linked to hormonally driven pathogenesis.
 
Characteristic activating oncogenic mutations or amplification and inactivating mutations or deletion of tumor suppressors are seen more in association with one type of mutation versus the other type, but some overlap exists. With the Cancer Genome Atlas and a full genetic display of hundreds of endometrial cancers, four subtypes have been identified that will refine classification and provide prognostic and therapeutic implications.[1]
 
The most common endometrial cancer cell type is endometrioid adenocarcinoma, which is composed of malignant glandular epithelial elements; an admixture of squamous metaplasia is not uncommon. Adenosquamous tumors contain malignant elements of both glandular and squamous epithelium;[2] clear cell and papillary serous carcinoma of the endometrium are tumors that are histologically similar to those noted in the ovary and the fallopian tube, and the prognosis is worse for these tumors.[3] Mucinous, squamous, and undifferentiated tumors are rarely encountered. Frequency of endometrial cancer cell types is as follows:
 
Endometrioid (75%–80%).
 
Ciliated adenocarcinoma.
Secretory adenocarcinoma.
Papillary or villoglandular.
Adenocarcinoma with squamous differentiation.
 
Adenoacanthoma.
Adenosquamous.
 
Uterine papillary serous (<10%).
Mucinous (1%).
Clear cell (4%).
Squamous cell (<1%).
Mixed (10%).
Undifferentiated.<gallery>
Image:Endometrial stromal sarcoma gross.jpg|Endometrial stromal sarcoma
Image:Uterine carcinosarcoma.jpg|Malignant mixed müllerian tumor
</gallery>


==References==
==References==
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Latest revision as of 18:41, 26 November 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Roukoz A. Karam, M.D.[2]

Overview

Endometrial cancer may be classified according to histology into either type I comprising 80% of endometrial cancers or type II accounting for around 20%.

Classification

Endometrial cancer may be classified according to histology into 2 types:[1]

Type Histology Prognosis Pathogenesis Prevalence
Type I Endometroid (adenocarcinoma) Favorable (estrogen-responsive) • May arise from atypical hyperplasia
• Linked to unopposed estrogen stimulation 		80%
Type II • Endometroid
• Serous
• Clear cell
• Mucinous
• Squamous
• Mesonephric
• Undifferentiated 		Typically bad prognosis • Develops from atrophic endometrium
• Not linked to hormonally driven pathogenesis 		15-20%

References

  1. ↑ Bokhman JV (1983). "Two pathogenetic types of endometrial carcinoma". Gynecol Oncol. 15 (1): 10–7. PMID 6822361.


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