Endometrial cancer overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Endometrial cancer refers to several types of malignancy which arise from the endometrium, or lining of the uterus. Endometrial cancers are the most common gynecologic cancers in the United States, with over 35,000 women diagnosed each year in the U.S. The most common subtype, endometrioid adenocarcinoma, typically occurs within a few decades of menopause, is associated with excessive estrogen exposure, often develops in the setting of endometrial hyperplasia, and presents most often with vaginal bleeding. Because symptoms usually bring the disease to medical attention early in its course, endometrial cancer is only the third most common cause of gynecologic cancer death (behind ovarian and cervical cancer). A hysterectomy (surgical removal of the uterus) is the most common therapeutic approach.
Endometrial cancer may sometimes be referred to as uterine cancer. However, different cancers may develop from other tissues of the uterus, including cervical cancer, sarcoma of the myometrium, and trophoblastic disease.
Classification
Endometrial cancer may be classified according to histology into 7 subtypes: endometrioid, uterine papillary serous, mucinous, clear cell, squamous cell, mixed and undifferentiated.
Pathophysiology
Development of endometrial cancer is the result of multiple genetic mutations. Genes involved in the pathogenesis of endometrial cancer include TP53, KRAS, and PTEN. The pathophysiology of endometrial cancer depends on the histological subtype.
Differential diagnosis
Endometrial cancer in early stage must be differentiated from diseases that cause abnormal uterine bleeding and endometrial thickening on USG, such as endometrial hyperplasia , endometrial polyp, and submucosal uterine leiomyoma. In advanced stages endometrial cancer must be differentiated from uterine sarcoma and uterine lymphoma.