Endometrial cancer classification: Difference between revisions

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Revision as of 15:03, 1 September 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Classification

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.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.

Endometrial stromal sarcoma
Malignant mixed müllerian tumor

References

Template:WikiDoc Sources

@@ Line 5: / Line 5: @@
 ==Overview==
 ==Classification==
-Most endometrial cancers are [[carcinoma]]s (usually [[adenocarcinoma]]s), meaning that they originate from the single layer of [[epithelium|epithelial]] cells which line the endometrium and form the endometrial glands. There are many [[histopathology|microscopic]] subtypes of ''endometrial carcinoma'', including the common ''endometrioid'' type, in which the cancer cells grow in patterns reminiscent of normal endometrium, and the far more aggressive ''papillary serous'' and ''clear cell'' endometrial carcinomas. Some authorities have proposed that endometrial carcinomas be classified into two pathogenetic groups:<ref>{{cite journal |author=Bokhman JV |title=Two pathogenetic types of endometrial carcinoma |journal=Gynecol. Oncol. |volume=15 |issue=1 |pages=10-7 |year=1983 |pmid=6822361 |doi=}}</ref>
+Cellular Classification of Endometrial Cancer
-====Type I:====
+Endometrial cancers are classified in one of the following two categories:
-These cancers occur most commonly in pre- and peri-[[menopause|menopausal]] women, often with a history of unopposed [[estrogen]] exposure and/or [[endometrial hyperplasia]]. They are often minimally invasive into the underlying uterine wall, are of the ''[[Grading (tumors)|low-grade]] endometrioid'' type, and carry a good prognosis.
-====Type II:====
+Type 1 may arise from complex atypical hyperplasia and is pathogenetically linked to unopposed estrogenic stimulation.
-These cancers occur in older, post-menopausal women, are more common in African-Americans, and are not associated with increased exposure to estrogen. They are typically of the ''[[Grading (tumors)|high-grade]] endometrioid'', ''papillary serous'' or ''clear cell'' types, and carry a generally poor prognosis
+Type 2 develops from atrophic endometrium and is not linked to hormonally driven pathogenesis.
-In contrast to ''endometrial carcinomas'', the uncommon ''endometrial stromal [[sarcomas]]'' are cancers which originate in the non-glandular [[connective tissue]] of the endometrium. ''Malignant mixed müllerian tumor'' is a rare endometrial cancer which contains cancerous cells of both glandular and [[connective tissue]] appearance - in this case, the cell of origin is unknown.<ref name="Weidner's">{{cite book |author=Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor) |title=Modern Surgical Pathology (2 Volume Set) |publisher=W B Saunders |location=London |year= |pages= |isbn=0-7216-7253-1 |oclc= |doi=}}</ref>
+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]
-<gallery>
+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.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

Endometrial cancer classification: Difference between revisions

Revision as of 15:03, 1 September 2015

Overview

Classification

References

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