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What is True about endometrial carcinoma : and explain in detail?
Ans. is a i.e. Predisposed by Diabetes mellitus, hypeension and obesity Endometrial cancer : Most common in nulliparous females.deg Age group : Peak incidence 60 years (6'"-7'h decade most common).deg But in 25% cases can occur before menopause or in young females. Race : Most common in Jews (Unlike Ca cervix). Predisposing Factors : Already discussed in detail earlier. A combination of hypeension, diabetes and obesity in association with Endometrial Ca is known as Corpus Cancer Syndrome. Associated diseases : -- Fibroid uterusdeg (as it also occurs in Nulliparous females) -- Cervical Polypsdeg Pathology : Most common variant is Adenocarcinomadeg (known as Endometroid and not Adenosquamous). Only 15-20% of Adenocarcinomas may have squamous differentiation. Histology : Endometrial carcinoma can be distinguished from hyperplasia by : Back to back arrangement of Glandsdeg No intervening stromadeg Desmoplastic stroma Extensive papillary pattern Squamous epithelium differentiationdeg Clinical features : A female of perimenopausal age group( 6th -71" decade) presents with : Abnormal bleeding (90% cases) in the form of metrorrhagia menometrorrhagia, intermenstrual spotting, postmenopausal bledding Discharge (1%) P/V : -- Brown, watery offensive discharge -- Watery discharge free from blood (hydrorrheadeg). Pelvic pressure/discomfo. Referred pain in hypogastrium or both iliac fossae (Simpson's pain).Pain tsevere and tends to occur at the same time each day, lasting on 1-2 hrs (Impoant). In some older patients, bleeding may not occur due to cervical stenosis. causing hematometra/pyometra. Desmoplastic stromadeg Extensive papillary pattern Squamous epithelium differentiationdeg Clinical features : A female of perimenopausal age group( 6th -71" decade) presents with : Abnormal bleeding (90% cases) in the form of metrorrhagia menometrorrhagia, intermenstrual spotting, postmenopausal bledding. Discharge (1%) P/V : -- Brown, watery offensive discharge -- Watery discharge free from blood (hydrorrheadeg). Pelvic pressure/discomfo. Referred pain in hypogastrium or both iliac fossae (Simpson's pain). Pain tsevere and tends to occur at the same time each day, lasting on 1-2 hrs (Impoant). In some older patients, bleeding may not occur due to cervical stenosis. causing hematometra/pyometra.