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.