ADENOCARCINOMA OF ENDOMETRIUM
A 63 year old woman presented with a history of dull lower abdominal pain for 2 months and heavy persistent vaginal bleeding for 1 week. The menopause had occurred 13 years previously. On examination, there was blood in the vagina, the cervix was atrophic and the uterus was not palpable. A hysterectomy was performed. Post-operative recovery was complicated by the development of deep venous thrombosis of the legs.
The specimen consists of uterus, fallopian tubes and ovaries. The endometrial cavity and endocervical canal have been opened on the posterior aspect and the specimen is viewed from behind. At the fundus there is a brown polypoid tumour 38 x 45 mm in diameter projecting into the uterine cavity. Histologically this was a well differentiated adenocarcinoma of the endometrium.
Endometrial carcinoma usually occurs in post-menopausal women and often presents with a history of post-menopausal bleeding. Endometrial carcinoma is associated with a number of predisposing factors, including prolonged oestrogen stimulation, nulliparity, obesity, diabetes and hypertensioqn. Prolonged oestrogen therapy for menopausal symptoms may be a risk factor. In a small proportion of cases, there is an associated endometrioid carcinoma of the ovary, which may be bilateral.