Endometrial Adenocarcinoma

by Carlo Raj, MD

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    00:01 Our topic now, brings us into endometrial adenocarcinoma.

    00:05 At this point, I’m hoping by you looking at this picture and that area that you see here in which it’s circular, the cells that are surrounding the circular area are lined by what’s known as your columnar glandular cells.

    00:20 And you find this to be, well, increased in number, increased, increased glandular cells.

    00:26 While here we have endometrial adenocarcinoma, it is the most common invasive cancer of the female genital tract.

    00:31 Yes, that’s true if your patient may be coming from a developed country.

    00:36 If however she’s coming from a developing country, then you’re thinking more along the lines of cervical invasive cancer and that is something that we already pointed out.

    00:45 Here as well, as I told you earlier, with endometrial adenocarcinoma, you want to group this together with hyperplasia and the reason for that is the risk factors will be relatively similar.

    00:57 Lots of estrogen exposure and symptoms here once again, you’re looking for bleeding that’s taking place in a female postmenopausal from the cervical os.

    01:08 Uncommon in women younger than age 40.

    01:11 That’s important for you to know.

    01:13 As I said, post menopausal.

    01:16 The risk factors for adenocarcinoma.

    01:18 Here once again, estrogen exposure, obesity, infertility, lots of estrogen.

    01:25 The cancer cells are subsets.

    01:28 The subset of patients usually older develop what’s known as high-grade papillary serous carcinoma without a background of hyperplasia and that’s extremely dangerous.

    01:38 So here, you kind of have a patient that goes onto endometrial cancer without any predisposing factor.

    01:44 Scary.

    01:45 It would be nice at least if there was some type of warning and maybe there was hyperplasia, nuclear atypia, and then at that point at least, you could take it -- I mean here also you’d be taking out the uterus, but at least you won’t have to worry about cancer per se.

    01:57 So without a background of hyperplasia, a papillary high-grade serous, at least know this.

    02:05 These exhibit what’s known as microsatellite instability and P53 mutation.

    02:10 The last time we talked about microsatellite instability was dealing with what was known as HNPCC.

    02:16 Hereditary nonpolyposis colorectal cancer.

    02:19 And during that time, I mentioned what microsatellite instability was and I also mentioned MLH1 and MSH2.

    02:26 Please do not forget, at least know one subset or one type of endometrial cancer known as your papillary serous in which a background or predisposing hyperplasia was not discovered.

    About the Lecture

    The lecture Endometrial Adenocarcinoma by Carlo Raj, MD is from the course Uterine and Fallopian Tube Disease.

    Included Quiz Questions

    1. It is the most common invasive cancer of the female genital tract in developed countries.
    2. It is the least common invasive cancer of the female genital tract in developed countries.
    3. It is less common than leiomyosarcoma worldwide.
    4. It is less common than sarcoma botyroides in females older than 40 years.
    5. It is more common than cervical carcinoma in developing countries.
    1. It usually occurs after a few months of developing endometrial hyperplasia.
    2. The patient population is usually older.
    3. It occurs without a background of endometrial hyperplasia.
    4. The cancer cells exhibit microsatellite instability.
    5. p53 mutations are present in the cancer cells.

    Author of lecture Endometrial Adenocarcinoma

     Carlo Raj, MD

    Carlo Raj, MD

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