Endometrial carcinoma

Epidemiology and pathogenesis Cancer of the uterine corpus is the most common gynecological cancer in the USA, with over 46 000 cases diagnosed annually. Endometrial carcinoma is by far the most common of the uterine cancers. Other malignancies of the uterus include leiomyosarcomas, carcinosarcomas, and endometrial stromal sarcomas. The mean and median age at diagnosis of women with endometrial carcinoma is 61 years. Less than 5% of cases occur in women younger than age 40, and 90% occur in women older than age 50. Approximately 80% of cases are diagnosed after the menopause. Histology Endometrial carcinoma is divided into several histological types: endometrioid clear cell mucinous papillary serous secretory squamous transitional cell. Endometrioid adenocarcinoma is the most common. The endometrioid adenocarcinoma can have areas of squamous metaplasia (adenoacanthoma) or areas of squamous carcinoma (adenosquamous carcinoma). In these cases, the preferred histopathological diagnosis is endometrial adenocarcinoma with benign or malignant squamous differentiation. The prognosis in endometrioid endometrial adenocarcinoma with squamous differentiation is associated with the grade of the glandular component rather than the presence of a malignant squamous component. However, a malignant squamous component is usually associated with a grade 3 endometrioid adenocarcinoma; this is associated with a higher stage of cancer and a worse prognosis.