Endometrial cancer differential diagnosis

Endometrial cancer Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]Roukoz A. Karam, M.D.[3]

Overview

In early stages endometrial cancer must be differentiated from diseases that cause abnormal uterine bleeding and endometrial thickening on ultrasound, such as endometrial hyperplasia, endometrial polyp and submucosal uterine leiomyoma. In advanced stages endometrial cancer must be differentiated from uterine sarcoma and uterine lymphoma.

Differentiating Endometrial Cancer From Other Diseases

• In early disease, uterine cancer must be differentiated from other diseases causing endometrial thickening:

• Benign endometrial proliferation
• Endometrial hyperplasia
• Endometrial polyp
• Submucosal uterine leiomyoma

• In advanced disease, uterine cancer must be differentiated from other diseases:

• Uterine sarcoma

• Endometrial stromal sarcoma (ESS)
• Leiomyosarcoma of the uterus
• Malignant mixed Mullerian tumour (MMMT) of the uterus

• Uterine lymphoma: rare

• Primary uterine lymphoma
• Secondary uterine involvement with lymphoma

• Cervical cancer with uterine invasion
• Metastasis to the uterus from a non gynaecologcial malignancy: rare

Diseases	Clinical manifestations							Para-clinical findings							Gold standard	Additional findings
	Symptoms				Physical examination
								Lab Findings			Imaging			Histopathology
	Vaginalbleeding	Pelvicpain	pelvicpressures	Abdominaldistentions	Pelvicmass	Abdominaldistension	Physical exam 3	Hb	CEA-19		Pelvic examination	Pelvicultrasound	MRI
Uterine cancer
Uterine sarcoma
Uterine lymphoma
Uterine leiomyoma
Malignant mixedMullerian tumour (MMMT) of the uterus
Cervical cancerwith uterine invasion
Metastasis to the uterusfrom a non gynaecologcial malignancy
Endometrial polyp
Endometrial hyperplasia
Fetus
Uterine adenomyoma
Hematometra

Diseases	Clinical manifestations						Para-clinical findings							Gold standard	Additional findings
	Symptoms			Physical examination
							Lab Findings			Imaging			Histopathology
	Symptom 1	Symptom 2	Symptom 3	Physical exam 1	Physical exam 2	Physical exam 3	Lab 1	Lab 2	Lab 3	Imaging 1	Imaging 2	Imaging 3
Uterine cancer
Uterine sarcoma
Infection
Diseases	Symptom 1	Symptom 2	Symptom 3	Physical exam 1	Physical exam 2	Physical exam 3	Lab 1	Lab 2	Lab 3	Imaging 1	Imaging 2	Imaging 3	Histopathology	Gold standard	Additional findings
Abscess
Septic emboli
Fungi
Differential Diagnosis 1
Differential Diagnosis 2
Differential Diagnosis 3
Diseases	Symptom 1	Symptom 2	Symptom 3	Physical exam 1	Physical exam 2	Physical exam 3	Lab 1	Lab 2	Lab 3	Imaging 1	Imaging 2	Imaging 3	Histopathology	Gold standard	Additional findings
Differential Diagnosis 4
Differential Diagnosis 5
Differential Diagnosis 6