Associated with hyperoestrogenic states:

Possible associations with:

Tamoxifen is an
estrogen receptor
antagonist

Obesity
Diabetes
Late menopause
Prolonged use of unopposed oestrogens
Estrogen secreting tumors
Long term tamoxifen

Previous pelvic irradiation

Lower parity

Etiology:

Pathology:
Usually adenocarcinoma
Spreads by invasion through myometrium
Spreads via cervical lymphatics involving
iliac and para-aortic lymph nodes
In advanced cases haematogenous spread
to lungs, liver, and bones

Mean age of presentation 56 years

80% menopausal women
Rare under the age of 40 years

Symptoms:
Post Menopausal Bleeding
Bloodstained discharge
Irregular bleeding

Management:
Surgery hysterectomy & Salpingooophorectomy
? Lymphadenectomy
In women with high grade disease - full
staging laporotomy & omental biopsy
Radiotherapy if unable to undergo surgery
& as adjuvant
Hormone therapy (progesterones) inhibit
rate of growth

Endometrial
Carcinoma

Post menopausal bleeding

should be assumed to be
endometrial Ca till proved
otherwise!

Signs:
Uterine enlargement (uncommon)
Bleeding through cervix

Investigations:
Staging:
Stage 1 - Ca confined to Uterus
Stage 2 - extension to cervix
Stage 3 - extension outside uterus but
within true pelvis
Stage 4 - involvement of the bladder,
rectum, or extension outside true pelvis

USS to assess dimensions of any tumor &

to show endometrial thickness (< 5mm
normal)