scholarly journals Frequency and characteristics of endometrial carcinoma and atypical hyperplasia detected on routine infertility investigations in young women: a report of six cases

2009 ◽  
Vol 24 (5) ◽  
pp. 1045-1050 ◽  
Author(s):  
H. Fujiwara ◽  
S. Ogawa ◽  
M. Motoyama ◽  
Y. Takei ◽  
S. Machida ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Young Women ◽  
Atypical Hyperplasia

Gonadotropin-Releasing Hormone Agonist Combined With a Levonorgestrel-Releasing Intrauterine System or Letrozole for Fertility-Preserving Treatment of Endometrial Carcinoma and Complex Atypical Hyperplasia in Young Women

2017 ◽  
Vol 27 (6) ◽  
pp. 1178-1182 ◽  
Author(s):  
Huimei Zhou ◽  
Dongyan Cao ◽  
Jiaxin Yang ◽  
Keng Shen ◽  
Jinghe Lang
Keyword(s):  
Endometrial Carcinoma ◽  
Young Women ◽  
Gonadotropin Releasing Hormone ◽  
Atypical Hyperplasia ◽  
Endometrioid Adenocarcinoma ◽  
Releasing Hormone ◽  
Gonadotropin Releasing Hormone Agonist ◽  
Intramuscular Injections ◽  
Well Differentiated

ObjectivesThe aim of this study was to evaluate the efficacy and safety with gonadotropin-releasing hormone agonist (GnRHa) combined with a levonorgestrel-releasing intrauterine system or an aromatase inhibitor (letrozole) in young women with well-differentiated early endometrial carcinoma (EC) and complex atypical hyperplasia (CAH).MethodsWe performed a retrospective analysis including the clinical characteristics of 29 patients younger than 45 years with early well-differentiated endometrioid adenocarcinoma of the uterus (EC) or CAH who were treated at the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, from January 2012 to April 2016. Eighteen patients were treated with the combination of intramuscular injections of GnRHa every 4 weeks with the levonorgestrel intrauterine hormonal system (Mirena® Bayer Health Care Pharmaceutical Inc, Wayne, NY) was inserted. Eleven patients were treated with the combination of intramuscular injections of GnRHa every 4 weeks with oral letrozole 2.5 mg daily. The patients underwent follow-up with endometrial sampling by hysteroscopy and curettage for endometrial response every 3 months.ResultsAfter a median follow-up of 18.7 months (range, 5.6–54.9 months), 15 women (88.2%) in the EC group and 12 women (100%) in the CAH group had complete response (CR) after GnRHa combination treatment. Among the women who achieved CR, 1 woman (8.3%) with CAH and 1 woman (5.9%) with EC had recurrence after CR, and they finally underwent a hysterectomy. Time to CR was similar in the 2 groups (4.5 ± 1.9 months in the CAH group vs 5.0 ± 2.9 months in the EC group). Ten women (34.5%) had CR after the first 3 months, 8 women (27.6%) had CR after 6 months, and 9 women (31.0%) had CR after 9 months.ConclusionsBoth GnRHa with the levonorgestrel-releasing intrauterine system and GnRHa with letrozole are alternative treatments for women with CAH and EC who desire fertility preservation. A larger multicenter trial of the fertility-preserving treatment is warranted.

Controversies in the management of early endometrial carcinoma: an update

2017 ◽  
Vol 6 (6) ◽  
pp. 2124 ◽  
Author(s):  
P. Reddi Rani ◽  
Jasmina Begum ◽  
K. Sathyanarayana Reddy
Keyword(s):  
Developing Countries ◽  
Endometrial Carcinoma ◽  
Young Women ◽  
Genital Tract ◽  
Best Practice ◽  
Management Strategies ◽  
Evidence Based ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing ◽  
Cure Rates

Endometrial carcinoma (EC) is the commonest genital tract malignancy in developing countries and is usually confined to the uterus at the time of diagnosis with excellent prognosis and high cure rates. But the management is associated with lot of controversies like in staging, best surgical approach, extent of lymphadenectomy, adjuvant therapy, fertility sparing surgery in young women etc. A thorough surgical staging is important to determine uterine and extrauterine spread and also understanding of the pathophysiology and management strategies to identify women who are at high risk and tailoring the adjuvant treatment if necessary without increasing the morbidity. This evidence based narrative review conducted by searching Medline (1994- 2015) and other online articles from Pubmed, Google scholar. Articles were selected based on their currency and relevance to the discussion they summarize the current literature to provide an approach to best practice management of early endometrial carcinoma.

scholarly journals Prevalence and characteristics of endometrial polyps in patients with abnormal uterine bleeding

2008 ◽  
Vol 65 (5) ◽  
pp. 349-352 ◽  
Author(s):  
Biljana Djordjevic ◽  
Jelena Milosevic ◽  
Zorica Stanojevic
Keyword(s):  
Endometrial Carcinoma ◽  
Statistical Significance ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Atypical Hyperplasia ◽  
Endometrial Polyps ◽  
Female Population ◽  
Group A ◽  
Malignant Changes ◽  
Group B

Background/Aim. The prevalence of endometrial polyps (EPs) in the general female population is about 24%. Abnormal uterine bleeding is frequently the presenting symptom of EPs. The aim of this study was to determine the prevalence and characteristics of EPs in patients with abnormal uterine bleeding. Methods. The prevalence and characteristics of EPs were investigated in 961 patients with abnormal uterine bleeding who underwent dilatation and curettage between January and December 2006. Regarding histopathological features of EPs (presence of atypical hyperplasia or endometrial carcinoma), patients were divided into two groups: group A - patients who had EPs and EPs with hyperplasia without atypia (n = 204) and group B - patients who had EPs with atypical hyperplasia and EPs with carcinoma (n = 7). Results. In 211 (21.94%) patients EPs were found with abnormal uterine bleeding. Histopathologically, there were 175 (82.94%) EPs, 29 (13.74%) EPs with hyperplasia without atypia, 5 (2.37%) EPs with atypical hyperplasia, and 2 (0.95%) EPs with endometrial carcinoma. Contrary to the patients with EPs and EPs with hyperplasia without atypia (group A), patients who had EPs with atypical hyperplasia and EPs with carcinoma (group B) were older (p < 0.05), and more commonly postmenopausal (p < 0.05) and with hypertension (p < 0.05), all of statistical significance. Conclusion. The prevalence of endometrial polyps in patients with abnormal uterine bleeding according to our data was 21.95%. Atypical hyperplasia and endometrial carcinoma were rarely confined to a polyp. Older age, postmenopausal period and hypertension may increase the risk of premalignant and malignant changes in endometrial polyps.

scholarly journals Loss of ten-eleven translocation 1 (TET1) expression as a diagnostic and prognostic biomarker of endometrial carcinoma

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259330
Author(s):  
Nien-Tzu Liu ◽  
Cherng-Lih Perng ◽  
Yu-Ching Chou ◽  
Pi-Shao Ko ◽  
Yi-Jia Lin ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Endometrial Carcinoma ◽  
Endometrial Hyperplasia ◽  
Expression Profiles ◽  
Gynecological Cancer ◽  
Dna Demethylation ◽  
Atypical Hyperplasia ◽  
Mrna Levels ◽  
Normal Endometrium ◽  
Expression Score

Endometrial carcinoma (EC) is the most common gynecological cancer. However, there is currently no routinely used biomarker for differential diagnosis of malignant and premalignant endometrial lesions. Ten-eleven translocation (TET) proteins, especially TET1, were found to play a significant role in DNA demethylation, via conversion of 5-methylcytosine (5-mC) to 5-hydroxymethylcytosine (5-hmC). TET1, 5-mC, and 5-hmC expression profiles in endometrial carcinogenesis are currently unclear. We conducted a hospital-based retrospective review of the immunohistochemical expression of TET1, 5-mC, and 5-hmC in 181 endometrial samples. A “high” TET1 and 5-hmC expression score was observed in all cases of normal endometrium (100.0% and 100.0%, respectively) and in most samples of endometrial hyperplasia without atypia (90.9% and 78.8%, respectively) and atypical hyperplasia (90.6% and 93.8%, respectively), but a “high” score was found in only less than half of the EC samples (48.8% and 46.5%, respectively). The TET1 and 5-hmC expression scores were significantly higher in normal endometrium and premalignant endometrial lesions than in ECs (p < 0.001). A “high” 5-mC expression score was observed more frequently for ECs (81.4%) than for normal endometrium (40.0%), endometrial hyperplasia without atypia (51.5%), and atypical hyperplasia (53.1%) (p < 0.001). We also found that TET1 mRNA expression was lower in ECs compared to normal tissues (p = 0.0037). TET1 immunohistochemistry (IHC) scores were highly proportional to the TET1 mRNA levels and we summarize that the TET1 IHC scoring can be used for biomarker determinations. Most importantly, a higher TET1 score in EC cases was associated with a good overall survival (OS) rate, with a hazard ratio (HR) of 0.31 for death (95% confidence interval: 0.11–0.84). Our findings suggest that TET1, 5-mC, and 5-hmC expression is a potential histopathology biomarker for the differential diagnosis of malignant and premalignant endometrial lesions. TET1 is also a potential prognostic marker for EC.

Endometrial carcinoma; ovarian dysfunction — a risk factor in young women

1991 ◽  
Vol 41 (2) ◽  
pp. 143-150 ◽  
Author(s):  
E. Dahlgren ◽  
L.-G. Friberg ◽  
S. Johansson ◽  
B. Lindström ◽  
A. Odén ◽  
...  
Keyword(s):  
Risk Factor ◽  
Endometrial Carcinoma ◽  
Young Women ◽  
Ovarian Dysfunction

Clinicopathologic study of uterine endometrial carcinoma in young women aged 40 years and younger

2005 ◽  
Vol 15 (4) ◽  
pp. 657-662 ◽  
Author(s):  
T. Ota ◽  
M. Yoshida ◽  
M. Kimura ◽  
K. Kinoshita
Keyword(s):  
Progesterone Receptor ◽  
Endometrial Carcinoma ◽  
Young Women ◽  
Myometrial Invasion ◽  
Hormonal Treatment ◽  
Primary Treatment ◽  
Careful Consideration ◽  
Clinicopathologic Study ◽  
Well Differentiated ◽  
Adequate Management

To clarify what constitutes the adequate management of uterine endometrial carcinoma in young women, we reviewed clinicopathologically 31 patients aged 40 years and younger between January 1991 and June 2004. As a primary treatment, 12 cases chose hormonal treatment with medroxyprogesterone acetate (MPA; 600 mg/day) due to no findings of myometrial invasion and diagnosis of a grade 1, well-differentiated adenocarcinoma. In remaining 19 cases, surgery was performed. All the 19 patients who received surgery as a primary treatment are alive, with no evidence of a recurrence of the disease. In the 12 patients who received hormonal treatment, 8 patients eventually received a hysterectomy because of recurrence or no response to MPA. Of these eight patients, myometrial invasion was recognized in three patients. One of the eight patients died of the metastasized disease to the liver and brain after hysterectomy. After hormonal treatment, 4 of the 12 patients were exempted from surgery and showed no evidence of recurrence. Two patients had viable children. Progesterone receptor was negative in one case that died. Careful consideration should be given to hormonal treatment with MPA for the conservative management of endometrial carcinoma in young women. Moreover, MPA is not always a consistent management for every patient

Sign in / Sign up

Export Citation Format

Share Document