Endometrieal Carcinoma

1. ENDOMETRIAL CARCINOMA
Isaac R. Abraham MBChB, M.Med
OBGY
IMTU
10/05/2018

2. INTRODUCTION
• A cancer that arises from the
endometrium (the lining of the
uterus or womb). It is the result of
the abnormal growth of cells that
have the ability to invade or spread
to other parts of the body.

3. Cont…
• Occurs most commonly after
menopause

4. SIGNS
• The first sign is most often vaginal
bleeding not associated with a
menstrual period.
• Pain during urination or sexual
intercourse.

5. RISK FACTORS
• Excessive unopposed estrogen
exposure.
• High blood pressure.
• Diabetes
• Endometrial cancer is the most
common uterine cancer in the US
accounting for 80%of cases.

6. • Nulliparity
• PCOS
• Estrogen secreting tumors of the
ovary.

8. Cont…
• Prolonged use of Combined Oral
Contraceptives seems to confer
some protection against the
tumor.

9. SCREENING
• There is no effective screening program.
• Occasionally cervical smears contain
endometrial cancer cells.
• Double thickness endometrial ultrasonic
thickness of 4mm or more indicates a
need for endometrial sampling

10. Symptomatology
• Postmenopausal PV bleeding.
• Postmenopausal PV discharge.

11. DIAGNOSIS
• Hysteroscopy with endometrial curettage or
endometrial sampling

15. Other groups
• Adeno-squamoid group
1. If the squamous cells are well differentiated
the tumour is termed adeno-acanthoma
(Histological Grade 1)
2. Poorly differentiated squamous cells merit
the name adeno-squamous carcinoma
(Grade 2).

18. Staging
• Done surgically
• Based on FIGO classifications
• Usually spreads slowly from the
endometria probably because of
poor lymphatic drainage of the
endometria and blood supply.

24. MANAGEMENT
• Mainstay of treatment is Surgical
removal of the uterus and adjuvant
chemotherapy afterwards.
• Total Abdominal Hysterectomy plus
bilateral salpingo-oophorectomy is
the recommended intervention.

25. Cont…
• Afterward peritoneal sampling is also
done to asses potential peritoneal
spread.
• Samples should also be taken from
other abdominal organs involved for
confirmation.

26. Cont…
• Few women are unfit for surgery
and caesium insertion radioactive
therapy may be employed for
these, but radiation alone is less
effective than combined surgical
and radiation treatment．

27. PROGNOSIS
• With the exception of stage 1 tumors
of histological grades I and II, the
prognosis is less favorable than many
gynecologists believe with an overall
5 year survival of 70％ approximately
Fortunately over 80％of cases are
diagnosed at stage 1．

28. • Stage 5 year survival
• I 85%
• II 68%
• III 42%
• IV 22%

30. THE END