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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ninety-two patients with invasive cervical cancer initially treated by standard hysterectomy were evaluated for features related to survival. The cell type included squamous cell (64) and adenocarcinoma (28). Posthysterectomy therapy included radiation therapy (78), pelvic lymphadenectomy (3), and radical parametrectomy (1). Hysterectomy was initially performed for the following indications: invasive lesion missed on cone biopsy, 17; hemorrhage at cone biopsy, 2; bleeding, 16; abnormal cytology, 13; presumed endometrial cancer, 9; known cancer, 7; pelvic relaxation, 5; planned therapy, 3; fibroids, 3; adnexal mass, 2; chronic discharge, 1; pyometra, 1; postpartum endometritis, 1. The cumulative 5-year survival for all patients was 68%, for squamous cell 80%, and for adenocarcinoma 41% (P = 0.0001). On postoperative evaluation 84 patients had presumed Stage I and 7 had parametrial involvement (Stage II). Patients with Stage I disease were then examined separately by cell type. Fifty-seven patients with squamous cell disease had cumulative 5-year survival of 85%. Radiation therapy in the immediate postoperative period produced a survival of 88%, compared to observation only with a 69% survival (P = .10). Patients with squamous cell disease and more than 50% cervical invasion had a 75% survival compared to a 96% survival for those with less than 50% (P = .02). The presence of disease at the surgical margins, grade, age, and increase in radiation therapy did not influence survival. Twenty-seven patients with presumed Stage I adenocarcinoma had a cumulative 5-year survival rate of 42%. Survival was significantly influenced by tumor grade (P = .018) and the amount of postoperative radiation therapy (P = .03), while age, amount of residual tumor, and presence of tumor at surgical margins did not influence survival. Patients with invasive squamous cell carcinoma treated by standard hysterectomy and postoperative radiation therapy have a prognosis similar to those treated initially by either radical surgery or radiation therapy. Patients with adenocarcinoma appear to have a significantly decreased survival when compared to patients with squamous cell disease and their prognosis is related to tumor grade and the amount of postoperative pelvic radiation.
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PMID:Invasive cervical cancer treated initially by standard hysterectomy. 229 56

Diagnostic imaging is important in differentiating benign and malignant pelvic tumors and in staging malignant tumors. Many imaging techniques are now available. We describe computed tomographic (CT) and magnetic resonance imaging (MRI) features of gynecologic tumors. The following nine CT parameters were evaluated in 251 cases of cervical cancer (the incidence of each feature is given in parentheses): 1) enlargement of the cervix (58%), 2) low density area(s) (LDA) in the cervical region (28%), 3) presence of a necrotic cavity (11%), 4) pyometra (16%), 5) irregularity or indistinctness of the cervical margin (20%), 6) abnormalities of the parametrium (41%), 7) tumor extension to the vagina (9%), 8) tumor extension to the bladder (20%), 9) lymphadenopathy (8%). The more advanced the stage, the more features tended to be present. On T2-weighted MRI, cervical cancer appeared as a high intensity image. There was a positive correlation (r = 0.79) between MRI and pathologic findings concerning the thickness of the residual cervical myometrium. MRI was distinctly useful in both the staging of cervical cancer and the determination of the extent of tumor invasion of the vagina and bladder. We used three criteria to classify patients with endometrial cancer, which appeared as LDA within the uterus on contrast enhanced CT: 1) LDA occupied less than 50% of the uterine region, 2) the minimum thickness of the normal myometrium was over 0.5 cm, 3) the ratio of maximum to minimum thickness of the normal myometrium was over 0.5. Patients who fulfilled all three criteria constituted group A (n = 33), and those who failed to meet all three were designated group B (n = 30). The rates of myometrial invasion through more than one third the thickness of the uterine wall were 15% in group A and 90% in group B. The rates of lymphatic or vascular invasion were 15% and 57%, respectively, and of extrauterine invasion or metastasis 9% and 47%. Each of these differences was significant (p less than 0.01). Metastasis was detectable by CT in four group B patients. On T2-weighted MRI, endometrial cancer exhibited high intensity. A positive correlation (r = 0.94) was obtained between MRI data and pathologic findings concerning the thickness of residual normal myometrium. Preoperative differentiation of benign and malignant ovarian tumors is important.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Role of X-ray CT and magnetic resonance imaging in the diagnosis of gynecological malignant tumor]. 280 44

Curettage of a sixty-four-year-old white woman with post-menopausal metrorrhagia revealed pyometra and squamous papilloma, thought to be arising from the cervix. Presence of parakeratotic squamous epithelial cells in endometrial curettage, three years after the first clinical presentation, aroused suspicion of verrucous carcinoma of the endometrium. Uterus revealed a warty tumour with a histological picture characteristic of verrucous carcinoma. Radical surgical excision was followed by a disease-free observation period of 2 1/2 years.
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PMID:Verrucous carcinoma of the endometrium. A case report. 321 82

Primary endometrial carcinomas from 35 non-treated patients were investigated by measurement of androgen receptors in the tumor cytosols. Receptor analysis was done with a labelled synthetic androgen, methyltrienolone 3H-R1881 and triamcinolone acetonide, and dextran-coated charcoal absorption. The concentrations of androgen receptors in the endometrial carcinomas were, in decreasing order: highly-differentiated tumors, 15.7 +/- 1.8 (fmol/mg protein, mean +/- SE) (number of cases, 21); moderately differentiated tumors, 4.6 +/- 1.6 (n = 7); poorly differentiated tumors, undetectable in 7 out of 8 cases. Highly-differentiated tumors contained a much greater concentration of receptors than the two less differentiated ones. One highly-differentiated endometrial carcinoma with pyometra virtually lacked the receptor. The moderately differentiated endometrial carcinomas contained very low levels of the receptors. The poorly differentiated tumors virtually lacked the receptors. Metastatic lymph nodes from primary endometrial carcinomas with moderate differentiation had a very low receptor level. From these results, it is concluded that human endometrial carcinomas, particularly with histologically high differentiation, contain a considerable amount of androgen receptor and that the receptor concentrations appear to correlate with the histologic grade of tumor differentiation.
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PMID:Correlation of androgen receptors with histological differentiation in human endometrial carcinomas. 387 14

Lately there is a tendency for an increase in the incidence of endometrial cancer both in this country and other industrialized countries such as the United States. The routine cervicovaginal smear method is generally poor for the detection of endometrial carcinoma as compared to that used for the diagnosis of early cervical neoplasms. The principal reason for the poor detection rate is that the cells are not obtained directly from the lesion as is the case with disease of the cervix. Various techniques for obtaining endometrial cells directly from the lesions have been described, but none has enjoyed wide acceptance by the clinicians. The patients for this study consisted of 138 women who were referred to us for diagnostic curettage. We employed the new disposable device, the Endocyte, and Masubuchi's endometrial aspiration and compared the results. After obtaining specimens with both methods curettage was performed on all patients. In addition, the Endocyte was employed on 8 patients with endometrial carcinoma in another hospital, and the following results were obtained. 1. With the Endocyte it is possible to obtain a larger volume of cells than by aspiration. 2. Although a certain amount of difficulty is encountered in the insertion of the Endocyte in some cases, it is much easier than the brush method used heretofore. 3. No significant difference in the amount of bleeding after insertion could be observed between the two methods. 4. In patients with bleeding in the endometrium and pyometra it is easier to obtain specimens from the endometrium with the Endocyte than by aspiration. 5. With the Endocyte contamination of the cells of the cervix was less than after aspiration. 6. Although pain during collection of cells with the Endocyte was somewhat stronger than during aspiration, analgesics were not necessary in any one of the cases. 7. The Endocyte was used on 13 patients with endometrial carcinoma, and all specimens were positive for carcinoma. From the results of our study we conclude that for endometrial cytology the Endocyte is as useful as the aspiration method. Furthermore, it should pose no difficulty to the gynecologists to use the Endocyte because the Endocyte resembles IUD structurally.
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PMID:[Endometrial cytology by endocyte and by Masubuchi's aspiration technic --a comparative study--]. 717 79

Pyometra is a relatively common event. However, it is extremely rare for this condition to perforate spontaneously into the peritoneum, and to date only 14 cases have been reported in English literature. We recently experienced such a case in a patient with cervical cancer. The clinical features, pathologic findings, diagnosis, therapy, and outcome of these 15 cases were reviewed. Only 5 cases were associated with malignant diseases, consisting of 2 cervical cancers, 2 colon cancers, and 1 endometrial cancer. All of the patients developed generalized peritonitis, and 4 patients died of this. Correct preoperative diagnosis was difficult. Therefore, immediate and appropriate therapy is important.
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PMID:Spontaneous perforation of pyometra presenting as generalized peritonitis in a patient with cervical cancer. 840 7

Since the wide acceptance of serous carcinoma as a distinct subtype of endometrial carcinoma, almost all endometrial carcinomas with psammoma bodies have been classified as such. We describe eight cases of endometrioid endometrial adenocarcinoma with psammoma bodies and discuss their clinicopathologic features. The patients ranged in age from 37 to 79 years. Psammoma bodies were present in the curettage material in three and in the hysterectomy specimens in all cases. The tumors were well to moderately differentiated with at least focal squamous metaplasia. Four of eight cases also showed a focal villoglandular architecture. Inflammation and necrosis were present in all cases, and four had features of pyometra. Deep myometrial invasion was present in six cases. Diffuse lymphatic invasion was present in six, and one showed perivascular lymphocytic infiltrate in the absence of myometrial invasion. The tumors metastasized to lymph nodes in four of eight cases. One case showed intranodal psammoma bodies in the absence of endosalpingiosis or tumor. Intra-abdominal recurrence was present in only one case and was endometrioid with rare psammoma bodies. All patients are alive, six with no evidence of disease, one with stable periaortic lymphadenopathy, and one with progressive disease. This report suggests that endometrioid endometrial carcinoma may rarely be associated with psammoma bodies, the formation of which is most likely due to inflammation and necrosis. It also suggests that endometrioid carcinoma with psammoma bodies has a higher surgical stage and is more likely to have lymphatic invasion and lymph-node metastases and hence require surgical staging. The pattern of spread appears to be different from uterine papillary serous carcinoma, and the rate of survival is similar to stage-matched endometrioid carcinoma without psammoma bodies.
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PMID:Endometrioid endometrial adenocarcinoma with psammoma bodies. 913 Sep 86

Most reports on histopathological findings of postmenopausal bleeding were published before hysteroscopy was widely used. Recent studies have shown that hysteroscopic examination is better than dilatation and curettage alone in detecting intrauterine pathology. The aim of this study is to assess histopathological findings of patients presented with postmenopausal bleeding after incorporation of hysteroscopic examination. Between 1 January 1996 and 31 December 1996, a total of 199 consecutive patients presenting with postmenopausal bleeding to a regional hospital were reviewed. Patients were investigated with cervical biopsy, endometrial aspiration or hysteroscopy and curettage. Excluding patients who had hysterectomy and cervical cancer, 97% of the patients had hysteroscopic examination. The majority of patients with postmenopausal bleeding had atrophic vaginitis and/or atrophic endometrium (58.8%). Other common diagnoses were endometrial polyp (9.4%), endometrial carcinoma (9.4%) and carcinoma of the cervix (6%). Other diagnoses included submucous fibroid, endometrial hyperplasia, pyometra, ovarian cancer and urethral caruncle. Pathologies found were similar to early reports, except that incidences of submucous fibroids and endometrial polyps were higher (13.4%). We concluded that all patients with postmenopausal bleeding should be investigated thoroughly as 22% have significant pathology. Hysteroscopy is the preferred investigation because of high incidences of endometrial polyps and submucous fibroids.
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PMID:Findings in women with postmenopausal bleeding investigated with hysteroscopy. 1252 35

The endometrial cavity may demonstrate various imaging manifestations such as normal, reactive, inflammatory, and benign and malignant neoplasms. We evaluated usual and unusual magnetic resonance imaging (MRI) findings of the uterine endometrial cavity, and described the diagnostic clues to differential diagnoses. Surgically proven pathologies of the uterine endometrial cavity were evaluated retrospectively with pathologic correlation. The pathologies included benign endometrial neoplasms such as endometrial hyperplasia and polyp, malignant endometrial neoplasms such as endometrial carcinoma and carcinosarcoma, endometrial-myometrial neoplasm such as endometrial stromal sarcoma, pregnancy-related lesions in the endometrial cavity such as gestational trophoblastic diseases (hydatidiform mole, invasive mole and choriocarcinoma) and placental polyp, myometrial lesions simulating endometrial lesions such as submucosal leiomyoma and some adenomyosis, endometrial neoplasms simulating myometrial lesions such as adenomyomatous polyp and endometrial lesions arising in the hemicavity of a septate/bicornate uterus, and fluid collections in the uterine cavity (hydro/hemato/pyometra). It is important to recognize various imaging findings in these diseases, in order to make a correct preoperative diagnosis.
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PMID:Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging. 1622 15

Endometrial cancer affects patients at every age, however it occurs more frequently in menopause (> 50) and in postmenopause (> 70). The most frequent symptoms are bleeding and vaginal discharge. When hematometra or pyometra is present the patient may feel pain. In some cases endometrial adenocarcinoma is asymptomatic and the diagnosis is casually made during ultrasound examination or by histological examination of a uterus surgically removed for other indications. In these cases the most frequent findings are polyps and abnormally increased thickness of the endometrial mucosa. In postmenopause polyps and abnormal endometrial thickness are usually limited to a small area and surrounded by atrophic mucosa. Higher incidence rates of endometrial cancer were correlated with polyps and an increased number of serous type tumors were identified in the > 65-year age group. Endometrial carcinoma may be estrogen correlated or non-estrogen associated. Patients in postmenopause are often affected by non-estrogen correlated endometrial carcinoma. According to Kurman and other authors the first type of endometrial adenocarcinoma (estrogen correlated) is characterized by low-grade malignancy. On the contrary, non-estrogen correlated neoplasia is more aggressive. In our case series including 102 women aged > 70 years with endometrial carcinoma we found that survival was correlated with stage and grading - early stages were the most frequent and the grade increased with stage. In fact all the patients with relapses had grade 2 or 3 adenocarcinomas. Thirty-one patients > 70 years (30.69%) had a non-endometrioid type of cancer.
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PMID:Endometrial cancer: asymptomatic endometrial findings. Characteristics of postmenopausal endometrial cancer. 1628 61


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