5. Uterine corpus Flashcards
Disorders of the endometrium
- Benign tumours of endometrium
- Endometrial hyperplasia
- Endometrial polyps - Endometrial carcinoma
- Endometriosis
Disorders of the myometrium
- Leiomyomas
- Leiomyosarcomas
- Adenomyosis
Etiology of endometrial hyperplasia
Increased estrogen stimulation leads to excessive proliferation of the endometrium
- Follicle persistence in anovulatory cycles
- Polycystic ovary syndrome (PCOS)
- Granulosa cell tumors
- Hormone replacement therapy without progestin administration (progestin normally prevents endometrial hyperplasia)
Clinical features of endometrial hyperplasia
Vaginal bleeding (intermenstrual, postmenopausal, or constant bleeding)
Definition of endometrial polyps
Focal overgrowth of localized benign endometrial tissue
Characteristics of endometrial polyps
- Localized within the uterine wall, extends into the uterine cavity
- Can be pedunculated or sessile, single or multiple, and up to many centimeters in size
Expresses both estrogen and progesterone receptors (estrogen stimulates growth)
Epidemiology of endometrial polyps
most common in postmenopausal women
Risk factors for endometrial polyps
- Hypertension
- Obesity
- Tamoxifen; postmenopausal hormone therapy
Clinical features of endometrial polyps
- Irregular menstrual bleeding, spotting, menorrhagia, and postmenopausal bleeding
- Infertility
Definition of endometrial cancer
- Type I endometrial cancer: endometrioid adenocarcinomas (grade 1 and 2) derived from atypical endometrial hyperplasia
- Type II endometrial cancer: endometrioid adenocarcinomas (grade 3) and tumors of nonendometrioid histology; serous, clear cell, mucinous
Etiology of Type 1 endometrial cancer
- Long-term exposure to increased estrogen levels
- Some genetic mutations (e.g., in the PTEN gene or mismatch repair genes) are also associated with this type of cancer.
Etiology of Type 2 endometrial cancer
- Estrogen-independent
2. Associated with endometrial atrophy (especially in postmenopausal women)
Risk factors for estrogen-dependent tumors
- Nulliparity
- Early menarche and late menopause
- Polycystic ovary syndrome
- Obesity
Protective factors for estrogen-dependent tumors
- Multiparity
2. Combination oral contraceptive pills
Epidemiology of endometrial carcinoma
- Primarily affect postmenopausal women
2. Peak incidence: 65–74 years