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

Although we encounter endometriosis not infrequently, the exact nature of this entity has not yet been determined. In order to study the morphogenesis of this disease, we chose the adenomyotic glandular epithelium as distinct ectopic glands and examined them in the electronmicroscope, comparing them with the proliferative phase of the endometrium and the uterine body adenocarcinoma. Five cases were selected from 76 histologically proven cases of adenomyosis at our University. Epon blocks were ultrasectioned with a Porter MT II microtome, stained with uranium acetate and lead, and observed in a JEM 100 C electronmicroscope. The characteristics of adenomyotic glandular epithelium compared to the normal proliferative endometrium were: 1) expanded smooth nuclear membrane with scattered fine chromatin and zero to one irregularly surfaced nucleoli, 2) in cytoplasm, rough ER and free ribosomes are distinct, mitochondria are round to oval in shape with moderate irregularity, and microfibrillar structures and interdigitations are present in moderate amounts. Although there are few similarities to endometrial cancer, these findings would suggest that adenomyosis may be an intermediate between the normal proliferative endometrium and endometrial cancer.
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PMID:[Ultrastructure of the ectopic endometrial glandular epithelium in five cases of adenomyosis--with particular reference to the normal proliferative endometrium and endometrial adenocarcinoma]. 402 Feb

Depth of myometrial invasion is accepted as one of the most important prognostic factors in carcinoma of the endometrium. In an effort to define the significance of adenomyosis containing adenocarcinoma as it relates to myometrial invasion, 52 cases of Stage I adenocarcinoma with coexisting adenomyosis were identified. A subset of 11 cases was noted to have adenocarcinoma in adenomyosis, invasive to a depth greater than would have been appreciated had this entity not been identified. These 11 cases had a 100% 5-year survival, suggesting that adenocarcinoma in adenomyosis does not indicate a more ominous prognosis. The depth of invasion into the myometrium proper is the significant prognostic factor. The pathologist must be able to differentiate these two distinct entities to accurately assess prognosis.
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PMID:The prognostic significance of adenomyosis in endometrial carcinoma. 669 51

Clinicopathologic investigations were carried out on 51 cases that had received hysterectomy and had been diagnosed histologically as adenomyosis uteri during a 4-year period since 1977, and the following results were obtained: 1) adenomyosis uteri was found in 51 out of 418 hysterectomized patients, the incidence being 12.2%, 2) 74.5% of the cases with adenomyosis uteri were in the fifth decade, the average being 44.8 years old, 3) 94% of the cases were gravidous, 82% being parous. The incidence of sterility was low in the case of adenomyosis uteri, 4) major symptoms of the adenomyosis uteri were dysmenorrhea and hypermenorrhea, and these symptoms increased in frequency as the degree of adenomyosis uteri progressed, 5) fibroid was a complication of the adenomyosis uteri in 25 cases, while endometrial carcinoma was observed in only 1 case, 6) the ectopic endometrium also showed the same changes in secretory conditions and menstrual changes as the surface endometrium, 7) many cases showed a difference in periodicity between the menstrual cycle and endometrial cycle, and also between the menstrual cycle and the ovarian cycle, and 8) in the ovary, luteinized cysts were observed in 21, 6% of all the cases, corpus luteum persistence in 27.5%, stromal hyperplasia in 33.3%, and follicular cysts in 64.7%. Both the stromal hyperplasia and the follicular cysts were found to increase in frequency as the degree of adenomyosis uteri advanced.
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PMID:A clinicopathologic study on adenomyosis uteri. 671 25

MR imaging has emerged as the most accurate imaging modality for the evaluation of many conditions affecting the uterus. This technique can both define the normal internal anatomy of the uterus and monitor the physiologic responses of this organ to various endogenous and exogenous stimuli. MR imaging provides unique diagnostic information that may guide therapeutic management of developmental anomalies, adenomyosis, and endometrial carcinoma.
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PMID:Magnetic resonance imaging of the uterus. 748 85

Many otherwise healthy women will experience a significant disruption in lifestyle from abnormal uterine bleeding. Most of those seeking medical attention will not be at risk for developing anemia. In each case, a thorough search for underlying systemic, hormonal, and organic causes should be instituted. The use of blind endometrial sampling to evaluate the uterine cavity, by itself, is an inaccurate technique for diagnosing pathologic conditions commonly associated with menorrhagia, such as endometrial polyps, submucous myomata, and focal endometrial abnormalities including adenocarcinoma and its precursors. The supplementary application of diagnostic hysteroscopy with directed biopsy will ensure the recognition of these intracavitary lesions. The majority of women found to have endometrial polyps and submucous myomata can gain a successful reduction in their menstrual flow without hysterectomy by undergoing hysteroscopic removal of these lesions. Those without other uterine or pelvic pathology and who are closer to perimenopause are more likely to sustain long-lasting relief from these procedures. Medical therapy should be the first line of treatment for premenopausal women who are found to have no obvious cause for their abnormal uterine bleeding. Many of those who do not respond to, are unable to tolerate, or are unwilling to attempt this approach will undergo hysterectomy as the final answer. The absence of uterine pathology in most of these cases places an absolute demand on our specialty to innovate, and, whenever suited, to use more conservative surgical solutions. Our efforts to alter this behavior will undoubtedly be closely monitored by agents of managed care aiming to reward measures that reduce cost and improve the quality of care. The use of hysteroscopic ablation and resection to treat women suffering from intractable menorrhagia can safely and effectively reduce menstrual blood flow and should significantly curtail the performance of unnecessary hysterectomy. The comparative benefits and long-term advantages of these techniques beyond hysterectomy await the results of further studies. Furthermore, the risks of these hysteroscopic procedures to produce iatrogenic adenomyosis or to conceal or delay the usual signs of adenocarcinoma have yet to be ascertained. Vigilance for endometrial disease must not dwindle in the face of amenorrhea, as evidenced by a recent case report describing the development of endometrial carcinoma after 5 years of amenorrhea following endometrial electrocoagulation. Future methods of endometrial destruction for the control of abnormal uterine bleeding may include the nonhysteroscopic use of radio frequency, thermal transfer, hyperthermia, and photodynamic therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:What is the role of hysteroscopy in the management of abnormal uterine bleeding? 755

To evaluate the prevalence and risk factors for adenomyosis, the clinical records of consecutive women undergoing hysterectomy during a 3 year period were retrieved. Data were collected on indication for the intervention, general sociodemographic characteristics of the patients, age at menarche, parity, abortions, and menopausal status at surgery. Adenomyosis was diagnosed in 332 of the 1334 cases (24.9%). The condition was present in 146 of the 627 patients (23.3%) with fibroids and menorrhagia, 68 of the 265 (25.7%) with prolapse, 21 of the 98 (21.4%) with ovarian cysts, 19 of the 100 (19%) with cervical cancer, 31 of the 110 (28.2%) with endometrial cancer, 16 of the 57 (28.1%) with ovarian cancer, and 19 of the 77 (24.7%) with miscellaneous indications. These differences were not statistically significant (chi 2(6) = 11.14). In comparison with nulliparous women, the odds ratio was 1.3 and 1.5 respectively in women with one and > or = two births (chi 2(1) trend = 5.76 P < 0.05). No relationship was found between age at surgery, age at menarche, indications for surgery, menopausal status at intervention, and presence of endometriosis. Our findings do not support the notion that adenomyosis is more frequently related to particular clinical conditions, and suggest that parity may be associated with an increased frequency of adenomyosis.
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PMID:Adenomyosis at hysterectomy: a study on frequency distribution and patient characteristics. 765 58

The value of magnetic resonance imaging (MRI) in the diagnosis and staging of endometrial carcinoma was studied in 43 cases of clinically suspected endometrial carcinoma and 7 normal women. All of the 43 cases showed abnormal endometria measured by MRI, among which were pathologically proven 40 cases of endometrial carcinoma, 2 cases of endometrial polyps and 1 case of adenomyosis. This suggested that MRI showed a high susceptibility in the diagnosis of endometrial carcinoma, and a lack of specificity. MRI could predict myometrial invasion, its accuracy being verified by surgico-pathological findings in 11 of 13 cases. MRI staging was correct in 10 of the 13 primarily operated cases, and only half of the clinical staging was in conformity with surgical staging. The results suggest that MRI is useful in the staging of endometrial carcinoma and therefore is of value in the choice of treatment planning, although it is not yet an ideal diagnostic aid to detect small metastatic pelvic lesions.
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PMID:[Magnetic resonance imaging in the diagnosis and staging of endometrial carcinoma]. 766 7

In support of a possible clinical use of gonadotropin-releasing hormone (Gn-RH) analogs in the treatment of the endometrial carcinoma, this study was undertaken to establish the presence and characteristics of Gn-RH receptor on endometrial cancer. Materials were human endometrial carcinomas surgically removed and endometrial carcinoma cell lines. Gn-RH receptor was characterized by [3H]Gn-RH binding to plasma membrane preparations. Gn-RH receptor messenger ribonucleic acid (mRNA) was determined by reverse transcription-polymerase chain reaction (PCR) using oligonucleotide primers synthesized according to the published human Gn-RH receptor sequence. Specific Gn-RH binding sites were shown to be present in 16 of 18 well-differentiated and 4 of 7 poorly differentiated adenocarcinoma specimens (Kd = 5.89 +/- 3.59 nM, Bmax = 1.80 +/- 0.95 pmol/mg protein) and cell lines RL95-2 and HHUA with Kd of 2.38 +/- 0.86 nM. The high-affinity binding sites were also detected in six proliferative-phase endometrium (Kd = 4.24 +/- 2.32 nM, Bmax = 2.73 +/- 1.12 pmol/mg protein). Gn-RH receptor mRNA was detected in all endometrial carcinoma and endometrial specimens and cell lines where the specific binding sites were detected, but not in adenomyosis or myometrial samples. The expression of Gn-RH receptor provides a possible point of attack for therapeutic approaches using Gn-RH analogs in this malignancy.
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PMID:Presence of gonadotropin-releasing hormone receptor and its messenger ribonucleic acid in endometrial carcinoma and endometrium. 795 56

With the advances in imaging technology and particularly magnetic resonance imaging and spiral computed tomography, questions have been raised whether these expensive modalities are affordable and cost effective. Although individual procedures are expensive, if applied as part of a logical decision trees, with proper indications and without duplications and redundancies they can obviate hospitalization and more costly exploratory laparotomy with its increase in morbidity and mortality. However, less costly techniques like ultrasound have their place as the primary approach, and it is important to know where problem-solving CT or MR is needed. MR in particular can provide information about the type of congenital anomaly and allow then the optimal surgical approach. This can result in approximation of chances for conception, successful pregnancy and child bearing. Similarly, the distinction between adenomyosis and leiomyomas is of great importance (when uterine preservation is requested), and at present only MR can make this distinction which leads to therapeutic decisions and patient counseling. In carcinoma of the cervix, staging with MR can determine whether radical surgery or radiation therapy will be the proper treatment approach. In carcinoma of the endometrium, patients with papillary serous carcinoma, high grade lesions, and patients presenting as poor risks for surgical staging will benefit from staging with MR. Lastly, as over 40% of patients with carcinoma of the ovary are understaged at the time of initial laparotomy, imaging findings may lead to more appropriate surgical approaches. With respect to the choice of imaging, at present CT is the primary and MR is a problem-solving modality.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Magnetic resonance imaging of the female pelvis]. 796 3

Report about 8 patients with endometrial pathology during tamoxifen therapy: 1 endometrial cancer, 1 adenomyosis uteri and 6 endometrial polyps. The knowledge about effects of tamoxifen on endometrium and possibilities of prevention are discussed. Sonographic screening of patients during tamoxifen therapy and if need by endometrial biopsy is necessary especially if tamoxifen is given longer than 2 years. No more than 30 mg should given in adjuvant therapy.
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PMID:[Postmenopausal hemorrhage and endometrial cancer in tamoxifen therapy]. 814 80


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