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

Perimenopausal and postmenopausal substitutive estrogen treatment is valuable if prescribed according to proper indications and in the proper manner. Studies have shown a correlation between menopausal estrogen treatment and endometrial cancer. Siiteri hypothesized that estrone was the estrogen with a specific carcinogenic effect. A study undertaken in California indicates, however, that conjugated estrogens are associated with a lower risk of endometrial cancer. There is also strong indications that certain factors predispose a woman to endometrial cancer during menopausal estrogen treatment: obesity, the Stein-Leventhal syndrone, the Turner syndrome, hirsuitism caused by increased androgen activity, and family history of endometrial cancer. Menopausal estrogen treatment is prescribed in cases of menstrual disturbances, neurovegetative or vaso-motor disturbances, psychological disturbances, atrophy of the urogenital tract, or cases of calcium or fat metabolism disturbances which could lead to osteoporosis or arteriosclerosis.
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PMID:[Estrogen substitution and endometrial carcinoma]. 21 33

A patient with gonadal dysgenesis who developed endometrial carcinoma in her 31st year of estrogen therapy is discussed in relation to thirteen previously reported cases of carcinoma of the uterus in patients with Turner's syndrome. The pattern of steroid receptor proteins in the endometrial carcinoma was found to correlate with the degree of differentiation of the tumor as assessed by light and electron microscopy. The findings reflect a potential for continued hormonal responsiveness of the tumor.
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PMID:Gonadal dysgenesis with adenocarcinoma of the endometrium: an electron microscopic and steroid receptor analyses with a review of the literature. 35 68

Annual endometrial biopsy had been advocated for patients with Turner's syndrome. The practicality of using this procedure on patients with no symptoms of abnormal bleeding has been questioned; this study attempts to answer this issue. Charts of patients with Turner's syndrome from the Cleveland Clinic for the period 1951-75 were reviewed. A criteria was established for inclusion of patients in the study. 34 of 43 women who met the criteria returned for the follow-up and were given pelvic exam, Pap smear, and endometrial biopsy by Vabra aspiration. Of the 43 patients given substitution therapy, 13 were taking estrogen alone; 24 were on estrogen-progesterone therapy, and 6 had stopped taking estrogen (Table 1). The presenting symptom in all cases of endometrial adenocarcinoma was abnormal bleeding (menorrhagia or menometrorrhagia), suggesting a change from previous menstrual patterns. At high risk for developing endometrial carcinoma at an early age was patients with dysgenesis who were receiving estrogen replacement therapy. The results of this study suggest that annual endometrial sampling is not necessary for patients with Turner's syndrome. It is recommended, however, that an annual examination and a Pap smear of an endocervical specimen be performed. Should there be any sign of menstrual aberration, endometrial biopsy or dilatation and curettage should be done. The importance of careful follow-up should also be impressed on patients who are on estrogen therapy; not more than 1 year's supply of estrogen should be given to such patients.
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PMID:Turner's syndrome: results of estrogen therapy. 43 70

Endometrial carcino-sarcoma is a rare rapidly growing mixed muellerian tumor. The pathogenesis of this tumor is not definitely known. However, the current explanation favors the theory of the growth of this tumor from pluripotential sub-epithelial cells. The incidence of the tumor is increased in post-menopausal women. Many of these women have a history of radiotherapy of the genital organs for benign gynaecological disease. A causal relationship between occurence of carcino-sarcoma and estrogen treatment as in carcinoma of the endometrium is not mentioned in the literature. The clinical signs and symptoms are non-specific as in many other malignant tumors of the uterine body. The prognosis is very bad. The average survival from the onset of the first symptoms is only a few months. The treatment of choice appears to be total abdominal hysterectomy and bilateral salpingo-oophorectomy. Radical operations and ancillary radiotherapy and chemotherapy do not appear to improve the survival rate. The extremely rare coincidence of a carcino-sarcoma in a young woman with Turner Syndrome gonadal dysgenesis after five years of treatment with estrogen led to the present case report.
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PMID:[Endometrial carcino-sarcoma in a young woman with Turner syndrome (author's transl)]. 43 57

2 cases of endometrial carcinoma arising in patients with gonadal dysgenesis are reported. A 29-year-old woman originally presenting with menorrhagia was found to have developed Grade 1 adenocarcinoma 5 years later. The patient showed some features of Turner's syndrome, and analysis of blood lymphocytes revealed chromosomal mosaicism. Total hysterectomy and salpingo-oophorectomy were performed, and an extensive adenosquamous tumor was found. The patient has shown no evidence of tumor recurrence for 13 years. A 2nd patient, presenting with menorrhagia at 21 years of age, was found to have focal adenomatous hyperplasia Grade 2 within a year. She was placed on cyclic hormone therapy. 6 years after 1st examination Grade 1 adenocarcinoma with squamous metaplasia was diagnosed and removed by hysterectomy with wedge resection of the ovaries. This patient has also remained well for 7 years after the surgery. Perhaps the development of endometrial carcinoma in these cases, theoretically improbable because of the infantile uteri, is due to the high levels of unopposed endogenous estrogens. In light of this possibility, cyclic estrogen-progestogen therapy might be more appropriate than the traditional estrogen replacement therapy for treatment of cases of gonadal dysgenesis.
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PMID:Endometrial carcinoma in gonadal dysgenesis with and without estrogen therapy. 68 83

Patients with dysgenetic gonads and Turner syndrome are unlikely to develop endometrial carcinoma unless they have received unopposed estrogen replacement therapy. This case describes a 54-year-old woman with Turner syndrome and primary amenorrhea who developed adenocarcinoma of the endometrium without having received hormone replacement. Vaginal bleeding, a pelvic mass, and sepsis were the presenting symptoms. The patient also had diabetes mellitus and hypothyroidism. Polyglandular endocrine patterns are known to occur with a high frequency in these patients. The woman's chromosome studies revealed a modified 46,X,i(Xq) (isochromosome X). This is the first report of an isochromosome X patient to develop endometrial cancer without receiving estrogen replacement. The etiology of this rare case may be an increased propensity for patients with X-chromosome deletions to develop neoplasms in general, or extragonadal estrogen production.
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PMID:Endometrial adenocarcinoma without prior hormone replacement in a diabetic patient with gonadal dysgenesis. 156 85

Unopposed endogenous and exogenous estrogenic stimulation has been considered by most investigators to have a role in the pathogenesis of carcinoma of the endometrium. Although a few cases of "sarcomas" of the endometrium that had developed in an estrogenic setting have been reported, a clear-cut association between estrogenic stimulation and these forms of endometrial cancer has not been established. We report six cases of endometrial sarcomas complicating ovarian thecomas, polycystic ovarian disease, or prolonged estrogen therapy. Three ovarian thecomas, which are considered to be estrogenic tumors, were associated with endometrial malignant mullerian mixed tumor, mullerian adenosarcoma, and low-grade stromal sarcoma in postmenopausal women. Polycystic ovarian disease, a condition characterized by unopposed estrinism due to the peripheral conversion of excessive androstenedione to estrone, was found in a 27-year-old infertile woman with an endometrial malignant mullerian mixed tumor. A pure osteogenic sarcoma of endometrial stromal origin developed in a 28-year-old woman with gonadal dysgenesis (Turner's syndrome) who had received estrogens for 18 years. The sixth woman, with an empty sella turcica after radiation therapy of a pituitary adenoma, had an endometrial mullerian adenosarcoma at the age of 40 years after 16 years of estrogen therapy. None of these patients had had pelvic radiation therapy. The evidence from this series of cases and from six additional cases identified in the literature suggests that the risk of endometrial sarcomas may be increased by estrogen therapy or endogenous disorders that lead to unopposed estrogenic stimulation of the uterus.
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PMID:Endometrial "sarcomas" complicating ovarian thecoma, polycystic ovarian disease and estrogen therapy. 298 76

Endometrial cancer is the cause of considerable morbidity among women, but the disease has been underrated and its management more casual than its virulence warrants. Endometrial carcinoma is the most frequently diagnosed invasive neoplasm of the female genital tract in the US, and is third in incidence after breast and colonic cancer. The white population of the US has the highest age standardized incidence of endometrial cancer in the world, India and Japan have the lowest, and the European countries occupy intermediate positions. Between 75% and 80% of women diagnosed with endometrial cancer are postmenopausal, and the mean age at diagnosis is about 60 years. In many cases endometrial hyperplasia is misdiagnosed as frank malignancy. The predisposing factors for endometrial cancer seem to be obesity, hypertension, diabetes mellitus or an abnormal glucose tolerance curve, and prolonged or unopposed estrogen stimulation. Raised estrogen levels may occur in the following situations: 1) women with functioning ovarian tumors that produce estrogen; 2) women with polycystic ovarian disease; 3) women with ovarian dysgensis (Turner's syndrome) managed with estrogen replacement therapy; 4) women taking high estrogen sequential oral contraceptives (OCs); and 5) women undergoing estrogen replacement therapy. There is an increased risk of endometrial carcinoma associated with nulliparity. Carcinoma of the endometrium occurs in a variety of subtypes, the most frequent being adenocarcinoma, followed by adenocanthoma, adenosquamous carcinoma, clear cell carcinoma, papillary adenocarcinoma, and secretory carcinoma. Overall 5-year survival rates are 72% for adenocarcinoma, 68% for adenocanthoma, and 26% for adenosquamous carcinoma. The true extent of endometrial cancer can be ascertained only after exploratory laparotomy and then various therapies may be used according to the stage of the disease.
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PMID:Carcinoma of the endometrium. 637 16

Endometrial carcinoma in young women is uncommon. The majority of cases occur in women who have been taking oestrogen-containing oral contraceptives, in those with the Stein-Leventhal syndrome, or in those with gonadal dysgenesis treated by long-term oestrogen replacement therapy. We have observed 4 women under 40 years of age with adenocarcinoma of the uterus in whom chromosomal abnormalities associated with Turner's syndrome were confirmed only after the diagnosis of carcinoma had been made. None of these had received replacement oestrogen therapy. It is postulated that chromosomal abnormalities in young women with endometrial carcinoma are more common than previously thought. As the disease in this group appears to behave in a benign fashion, a conservative approach to therapy is advocated.
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PMID:Endometrial carcinoma in young women. 695 43

The association of Turner's syndrome and endometrial carcinoma has been previously established but has never been described in conjunction with a uterine papillary serous carcinoma (UPSC). This histological variant is usually found in considerably older women and has no clear relationship to the prior use of estrogen replacement therapy. Despite presenting with stage IV disease, treated by surgery and medroxyprogesterone only, this patient has had an 8-year disease-free remission, suggesting that radical debulking of an endocrine-responsive tumor may be of considerable benefit to some women with this unfavorable histological subtype of endometrial carcinoma.
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PMID:Uterine papillary serous carcinoma in a 32-year-old with Turner's syndrome. 815 98


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