6 - 2003-10-27Carcinoma of the Endometrium1CARCINOMA OF THE...

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Unformatted text preview: 2003-10-27Carcinoma of the Endometrium1CARCINOMA OF THE ENDOMETRIUMWen Di , M.D.Ph.D2003-10-27Carcinoma of the Endometrium2 One of the commonest gynecological cancersespecially in white Americansit occurs most often in postmenopausal womenup to 80of caseswith less than 5diagnosed under 40years of age2003-10-27Carcinoma of the Endometrium3There is no effective screening programmebut occasionally cervical smears contain endometrial cancer cells or double thickness endometrial ultrasonic thickness of 4mm or more indicates a need for endometrial sampling2003-10-27Carcinoma of the Endometrium4Risk Factors The actual cause of this cancer is unknown Estrogen given estrogen alone as postmenopausal hormone replacement therapy Estrogen secreting tumors of the ovary are associated with an increased incidence of endometrial carcinoma2003-10-27Carcinoma of the Endometrium5 There can be no doubt that oestrogen can alter the behaviour of this tumour but there is still a question about oestrogen as a primary causal agent Approximately 75of cases of endometrial cancer occur in the postmenopausal period when estrogen values are low and progesterone is absentNulliparity and PCO syndromewith defective progesterone synthesiscarry an increased risk2003-10-27Carcinoma of the Endometrium6 Only a proportion of obesediabetic and hypertensive women develop endometrial cancer and similarly only a proportion of women with endometrial cancer are obesediabetic or hypertensiveThe question remains whether estrogen is a causal agentor is acting in its normal capacity as a growth factor and is really to be regarded as a cocarcinogen2003-10-27Carcinoma of the Endometrium72003-10-27Carcinoma of the Endometrium8 Oral contraceptionespecially after long term usereduces the incidence of both endometrial and ovarian carcinomas2003-10-27Carcinoma of the Endometrium9 The endometrial hyperplasia induced by Tamoxifen produces endometrial polypsA report in the Lancet in 1999 suggested a four-fold increase in endometrial carcinoma2003-10-27Carcinoma of the Endometrium10SymptomatologyThe usual presenting symptom of endometrial carcinoma is postmenopausal bleeding which carries a 10risk of associated malignancy in the absence of hormone replacement therapy. Curettageor endometrial sampling is mandatory. Postmenopausal discharge from pyometra carries a 50 risk of associated malignancy. Pain may occur with pyometra or metastatic spread2003-10-27...
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This note was uploaded on 01/21/2012 for the course PDBIO 305 taught by Professor Woods,a during the Fall '08 term at BYU.

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6 - 2003-10-27Carcinoma of the Endometrium1CARCINOMA OF THE...

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