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Endometrial carcinoma
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Endometrial carcinoma

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Contributors: Mary N.W. Towner MD, Mitchell Linder MD
Other Resources UpToDate PubMed

Synopsis

Endometrial carcinoma is a cancer of the endometrial glands lining the uterine cavity. About 80% of endometrial carcinomas are a result of excess estrogen effect on the endometrial glands. The precursor to this type of endometrial carcinoma is known as endometrial intraepithelial neoplasia (EIN).

Endometrial carcinomas are more common in women of European descent and more likely to develop after menopause.

Most commonly, endometrial carcinoma develops in conditions that expose the uterus to estrogen, either for very prolonged periods of time, without opposing progesterone, or both. As such, obesity, polycystic ovarian syndrome (PCOS), anovulation, nulliparity, tamoxifen use (in postmenopausal woman), prolonged hormone replacement therapy with estrogen alone, and early menarche or late menopause are all variably potent risk factors for endometrial carcinoma.

There are genetic syndromes that predispose women to endometrial carcinoma, particularly Lynch syndrome (hereditary nonpolyposis colorectal cancer). This autosomal dominant syndrome should be strongly considered in women diagnosed with endometrial carcinoma before age 50. Lynch syndrome should also be suspected when the patient has a family history of endometrial, colorectal, ovarian, intestinal, or renal cancers.

Codes

ICD10CM:
C55 – Malignant neoplasm of uterus, part unspecified

SNOMEDCT:
254878006 – Endometrial Carcinoma

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Atrophic postmenopausal bleeding – Thin endometrial stripe on ultrasound.
  • Endometrial hyperplasia (benign or premalignant)
  • Endometrial polyp – May appear as thickened endometrial stripe on transvaginal ultrasound. Saline sonohysterogram can help identify.
  • Anovulatory bleeding in premenopausal woman – Will usually have irregular menses.
  • Intracavitary leiomyoma (fibroid) – May be seen on transvaginal ultrasound and/or saline sonohysterogram. 
  • Coagulation disorders (inborn or iatrogenic)
  • Hypothyroidism

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 06/27/2017
Last Updated: 12/26/2018
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Endometrial carcinoma
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Endometrial carcinoma : Abdominal pain, Pelvic pain, Vaginal bleeding, Vaginal discharge, Pelvic cramp
Imaging Studies image of Endometrial carcinoma
Sagittal color Doppler image of uterus with complex mass, with no internal vascularity, path proven endometrial sarcoma.
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