This article is not totally accurate and should be fact-checked against a reputable medical source. This disturbance in DNA mismatch repair leads to genetic instability in somatic cells. Nyree Griffin MD FRCR, Lee Alexander Grant BA (Oxon) FRCR, in Grainger & Allison's Diagnostic Radiology Essentials, 2013, Endometrial carcinoma, transvaginal US. The hyperplasia is further stratified by the presence or absence of cytologic atypia. meaning? If Pap smear results point to cancer, the gynecologist will usually conduct an ultrasound or collect a larger sample of tissue to determine the severity of the disease. Adenocarcinoma of the endometrium is the commonest histological subtype of endometrial cancer and accounts for up to 90% of such cases 1. Endometrial adenocarcinomas are the most common form of carcinoma of the endometrium and account for about 75% to 80% of all cases. This cancer occurs most frequently in postmenopausal women, though it can affect any female of reproductive age. This is called the stage and grade. In more than 50% of these cases the histologic type of both tumors is endometrioid, making it difficult for the pathologist to distinguished between metastasis or the presence of two primary cancers.8–10, The use of tamoxifen also increases the risk of developing endometrial adenocarcinoma and carcinosarcoma. Studies of patients with uterine papillary serous carcinoma and clear cell carcinoma do not show an association with estrogen use, obesity, diabetes mellitus, or hypertension.16,17, Terence J. Colgan, C. Meg McLachlin, in Comprehensive Cytopathology (Third Edition), 2008, Endometrial carcinoma is one of the most common cancers in women living in developed countries. Some of these cancers have squamous cells (squamous cells are flat, thin cells), as well as glandular cells. Adenocarcinoma can affect endocrine glands but more commonly affects organs with exocrine glands. In general, villoglandular endometrial adenocarcinoma is associated with a good prognosis, and uterine papillary serous carcinomas are not. It has been suggested that there are two types of endometrial carcinoma, type I and II (Table 45-2). If an intraluminal micropapillary or hobnail pattern is not conspicuous, or if discretely enlarged individual nuclei are not seen, the lesion may be misinterpreted as EIN (Fig. Endometrioid Carcinoma of Endometrium is the most common subtype of endometrial cancer, which begins in the lining of the uterus (the endometrium). Depending on the architectural complexity of the glands, the hyperplasia is described as simple or complex (Fig. On MRI, LGESS may appear as a large polypoid mass within an expanded endometrial cavity. Type I tumors are most often low grade, minimally invasive, and of the endometrioid or mucinous types. The symptom is usually abnormal genital bleeding. Extrauterine spread initially occurs through the lymphatic system. Endometrial cancer is a cancer that arises from the endometrium (the lining of the uterus or womb). With continued growth, there is progressive invasion of the underlying myometrium. *, Endometrial carcinoma, MRI. This cancer occurs most frequently in postmenopausal women, though it can affect any female of reproductive age. But then I feel like people should be compassionate and practical enough to realize that these services, which provide preventative care for endometrial and uterine cancers and the like, actually save the country money in the long run. Other situations associated with the development of endometrial adenocarcinoma include hypertension (1.5-fold increase in relative risk), diabetes mellitus (1.8-fold increase in relative risk), use of unopposed estrogen replacement therapy (fourfold increase in relative risk), and the presence of complex atypical endometrial hyperplasia (29-fold increase in relative risk).7 Endometrial adenocarcinoma is found in 5% to 15% of women with ovarian tumors that produce estrogen (e.g., granulosa-theca cell tumor). Definition. The most common symptom is genital bleeding in postmenopausal women. It is the result of the abnormal growth of cells that have the ability to invade or spread to other parts of the body. The prognosis in cases of endometrioid endometrial adenocarcinoma with squamous differentiation is associated with the grade of the glandular component rather than the presence of a malignant squamous component. The Lynch II syndrome has all of the preceding features, but in addition includes a number of extracolonic cancers (endometrial, ovarian, small intestine, gastric, pancreas, transitional cell carcinoma of the ureter and renal pelvis), the most common of which is endometrial adenocarcinoma. Endometrial cancer can be divided into two types: endometrioid Type 1 (G1, G2) has a hormonal driven etiology, while Type 2 is more aggressive (G3 endometrioid, clear cell and serous cancer type) and estrogen independent. Proceeding from the fact that the endometrium shows considerable sensitivity to the effects of sex hormones, in particular, estrogen, this oncology is a hormone-dependent cancer. Herein, we report a 62-year-old woman diagnosed as FIGO stage IC, grade I, endometrial carcinoma who was found to have isolated femur and tibia metastases just after comp-leting local radiotherapy. Adenocarcinoma of the uterus body is a malignant neoplasm that occurs from the tissues of the muscular or mucous membrane of the uterus. Ciliated cell carcinoma is also uncommon and is often associated with prior estrogen use. An individual who experiences any potential symptoms of this condition should schedule an appointment with a gynecologist immediately. A cervicovaginal smear, or even an endometrial curettage specimen, is not sufficient for the diagnosis. People get all hung up over the abortion issue and don't realize that that is only a very small part of their services. Note the thin rim of normal myometrium (black arrows). In the univariate analysis of the 5-year survival rate of 74 cases of G3 endometrioid adenocarcinoma, adnexal metastasis (P = 0.0027) and high pre-surgery CA19-9 values (P = 0.020) showed significantly low P -values for survival (Table 2). Since the expected mortality from endometrial adenocarcinoma is 15% (i.e., 0.24/1000 women taking tamoxifen), annual screening of the thousands of women who take tamoxifen could potentially prevent death from endometrial adenocarcinoma in only a small fraction of them. Stromal elements of carcinosarcoma tend to appear as low SI on T2WI and are intensely enhanced on contrast-enhanced T1WI. b = bladder.†, Xavier Matias-Guiu, Carlos Parra-Herran, in Gynecologic Pathology (Second Edition), 2020. Endometrial carcinoma is the most common malignancy of the female genital tract, with an estimated 39,000 new cases of invasive carcinoma of the endometrium and 3000 deaths in 1982. A two-type view of endometrial adenocarcinoma combines epidemiologic, clinical, histologic, and molecular genetic data, and provides a useful pathogenetic model supported by multiple lines of evidence (Figure 18.1).The two types are: endometrioid carcinomas and their variants (type 1) and the non-endometrioid (type 2) … Type 1 may arise from complex atypical hyperplasia and is pathogenetically linked to unopposed estrogenic stimulation. Very high SI small glandular epithelial cysts may often be observed within the mass on T2WI. A gynecologist can conduct a series of tests to check for adenocarcinoma. The incidence is thought to be increasing. DCE-MRI has better accuracy in evaluating the local extent of endometrial cancer than T2WI (Kinkel et al., 1999). Occasionally, a D&C is required to gather more tissue, but a biopsy is the logical first step to patients presenting with abnormal bleeding and/or pelvic pain. 1993 Dec;51(3):311-5. On DWI, endometrial carcinomas have high cellularity; therefore, they have decreased ADC compared with benign endometrial lesions. It occurs most frequently in postmenopausal women, though it can affect any female of reproductive age. Mutations of DNA mismatch repair genes in chromosome 2p (hMSH2) and chromosome 3p (hMLH1) account for 90% of HNPCC cases. If adenocarcinoma is in its early stages, a surgeon can usually remove only the affected area of endometrial tissue. A third route of spread can also occur along the round ligament and involve the superficial inguinal nodes. Treatment for endometrial adenocarcinoma typically involves surgery. Contrast-enhanced T1WI demonstrates endometrial carcinoma as a poorly enhanced lesion compared with the myometrium; thus, depth of invasion is clearly demonstrated. Endometrial carcinoma is by far the most common of the uterine cancers. I've seen a lot of advertising about it lately, and I think they've got it right when they say that you aren't just doing it for you, you're doing it for all the people around you who love you and don't want you to leave this earth early from something like an endometrial tumor. In view of the uncertain clinical significance of grade 2 pathologic findings, Taylor and colleagues12 proposed a two-tiered grading system to improve the reproducibility and the prognostic significance of the tumor grade. Adenocarcinoma (/ ˌ æ d ɪ n oʊ k ɑːr s ɪ ˈ n oʊ m ə /; plural adenocarcinomas or adenocarcinomata / ˌ æ d ɪ n oʊ k ɑːr s ɪ ˈ n oʊ m ɪ t ə /) (AC) is a type of cancerous tumor that can occur in several parts of the body. In developed countries, endometrial carcinoma is the most common invasive cancer of the female genital tract.61. The typical early growth pattern is usually exophytic into the endometrial cavity. However, this is not an ideal pathologic classification, as there is morphologic overlap between the two types, particularly in the setting of a high-grade tumor. A postmenopausal woman with endometrial cancer usually experiences abnormal vaginal bleeding, abdominal pain, and frequent cramps. Risk factors for type I carcinoma include chronic anovulation (e.g., Stein-Leventhal syndrome), obesity, diabetes, nulliparity, hypertension, hormonally active ovarian tumors, and late menopause. Persistent estrogen stimulation unopposed by progesterone leads to endometrial hyperplasia. Specialists check samples for signs of adenocarcinoma and other common gynecological problems. Obesity of 13 to 22 kg over ideal body weight is associated with a threefold increase in the relative risk of developing endometrial adenocarcinoma6; the increase in relative risk is 10-fold in women who are 23 kg overweight. There is marked thinning of the fundal myometrium (arrowheads) at the site of deep myometrial invasion.∫, Stage IC endometrial carcinoma (e) on a sagittal T2-weighted spin-echo (TSE 3500/100) image. (A) Sagittal US image shows a large endometrial mass (*). Endometrial adenocarcinoma is a common form of gynecological cancer that primarily affects the endometrium, the lining of the uterine walls. As the cancer progresses, a woman might experience fatigue, weakness, and nausea. MRI has contributed to preoperative assessment of endometrial carcinoma (Hricak et al., 2000c). Another MR finding is that LGESS mimics adenomyosis as a low SI intramyometrial mass on T2WI. (b) No disruption of subendometrial enhancement (arrows) in the early phase of DCE-MRI suggests absence of myometrial invasion. There are two main routes of lymphatic drainage from the body of the uterus. 45-1). Consequently, the mortality rate from endometrial carcinoma ranks ninth in comparison to other tumoral sites in Canadian women.9, Kevin C. Bylund, in Reference Module in Biomedical Sciences, 2015. The majority of these cancer cases are detected and diagnosed in women aged 50 years and older (postmenopausal women) Concluzie: adenocarcinom endometrial de tip endometroid moderat diferentiat (G2), corp uterin. I almost wish they had a separate division that provided non-abortion/contraception services so that it could be kept safe whenever the funding is cut. An estimated 41,200 new cases of endometrial cancer will be diagnosed in 2006, and 7,350 deaths will be attributed to endometrial cancer during the year (Jemal et al.). Endometrioid cancers start in gland cells and look a lot like the normal uterine lining (endometrium). It is characterized by poorly differentiated tumors (i.e., grade 3) or aggressive histologic types (e.g., papillary serous, clear cell) that deeply invade the myometrium. Eventually, the tumor may extend outside of the uterus into the upper vagina, parametrial tissues, adnexa, bladder, or colon. Segmental thinning and/or disruption of a low SI junctional zone suggest the presence of myometrial invasion. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Università degli Studi di Verona, Verona, Italy, The University of British Columbia, Vancouver, Canada, Stony Brook University Hospital, Stony Brook, United States, Laboratory Animal Medicine (Second Edition), Endometrial Lesions, Unusual Tumors, and Extrauterine Cancer, Comprehensive Cytopathology (Third Edition), Grainger & Allison's Diagnostic Radiology Essentials, Diagnostic Gynecologic and Obstetric Pathology (Third Edition), Modern Surgical Pathology (Second Edition), Magnetic Resonance Imaging and Spectroscopy, Lin et al., 2009; Rechichi et al., 2010; Takeuchi et al., 2009a. Estrogen induces mitotic activity of the endometrial epithelial and stromal cells. Magdalena Pikul; Adenocarcinoma intramucosum tubulo-papillare G2 – odpowiada Aleksander Ropielewski; Profil immunohistochemiczny Adenocarcinoma endometrioides – odpowiada Dr n. med. In these cases the preferred histopathologic diagnosis is endometrial adenocarcinoma with benign or malignant squamous differentiation. I suggest the Society of Gynecologic Oncology or cancer.net. Method: This study included 699 Japanese cases of endometrioid adenocarcinoma at the International Federation of Gynaecology and Obstetrics (FIGO) surgical stages I-IV (including 74 G3 cases). Deep myometrial invasion is suggested by focal interruption (open triangles) of the inner myometrium (closed triangles). Endometrial carcinoma usually shows relatively lower SI than the normal endometrium on T2WI (Figure 8). Women have about a 2.6% lifetime risk of developing… A high tCho peak from the tumor and a creatine peak from the residual myometrium may be observed on 1H-MRS (Takeuchi and Matsuzaki, 2011). In a study by Taylor and colleagues,12 two gynecologic pathologists independently reviewed 85 hysterectomy specimens from patients with endometrial carcinoma and had a difference of opinion of at least 1 grade in 26% of the specimens. Type 2 develops from atrophic endometrium and is not linked to hormonally driven pathogenesis. They are of endometrioid histology, are estrogen responsive, and have a favorable prognosis. Following surgery, most patients are encouraged to schedule regular appointments with their gynecologists to ensure that all cancerous tissue has been removed. The disruption of the SEE suggests the presence of myometrial invasion and is a useful finding, especially in a postmenopausal patient with an unclear junctional zone (Figure 9). Mia madre l'11 settembre ha subito un adenocarcinoma poliposo endometrioide moderatamente differenziato g2. Excluding cases associated with oral sequential contraceptives, adenocarcinoma of the endometrium in young women is rare, constituting about 3% of endometrial carcinomas. Pure squamous cell carcinomas of the endometrium are extremely rare. The mean and median age at diagnosis of women with endometrial carcinoma is 61 years.1 Less than 5% of cases occur in women younger than age 40, and 90% occur in women older than age 50.2. More than 75% of endometrial carcinomas are type I. The endometrium is thickened and irregular in this postmenopausal patient. Type II endometrial carcinoma is associated with a poorer prognosis than type I. 17.31A). Secretory carcinomas account for 2% of all endometrial carcinomas and have a very good outcome. Use the menu to see other pages.Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body. At present, it is also recommended that starting at age 30 they undergo annual transvaginal sonographic examination of the ovaries and serum CA 125 determination. An immunostain for p53 may be helpful (see Fig. This is probably related to the absence of progesterone in women who are infertile secondary to anovulation resulting in unopposed estrogen stimulation of the endometrium. Adenocarcinoma with squamous differentiation represents a continuum of lesions, ranging from adenoacanthoma, which is exceptionally well differentiated and has a benign-looking squamous component, to adenosquamous carcinoma, which is poorly differentiated and has a malignant squamous component. Isolated skeletal metastasis of endometrial carcinoma is very unusual. We noticed an increase of more aggressive G3 endometrioid endometrial adenocarcinomas. Furthermore, 20% to 50% of patients who undergo a hysterectomy a few weeks after endometrial sampling shows atypical simple or complex endometrial hyperplasia are found to have endometrial adenocarcinoma in the hysterectomy specimen.5. I. Imaoka, ... M. Takeuchi, in Comprehensive Biomedical Physics, 2014. The possible causes of adenocarcinoma endometrium are high levels of estrogen, hypertension, and obesity. The patient underwent progestational therapy and follow-up hysteroscopies and D&C to preserve fertility; she is alive and well 18 months Women who have suffered from other forms of cancer, especially breast, ovarian, or lung cancer, are at an increased risk of developing this condition. Endometrial adenocarcinoma is more common among members of families with hereditary nonpolyposis colorectal cancer ... G2, G3), and depth of myometrial invasion, which correlates strongly with the risk of lymph node metastasis and the patient's prognosis. For ThinPrep, the age groups were 43.8 Adenocarcinoma can happen in … A common diagnostic procedure known as a Pap test or Pap smear involves collecting small samples of surface endometrial cells for laboratory analysis. (a) Small endometrial carcinoma (arrow) shows intermediate signal intensity on sagittal T2-weighted image. Nordstrom B, Strang P, Lindgren A, Bergstrom R, Tribukait B.: Endometrial carcinoma: the prognostic impact of papillary serous carcinoma (UPSC) in relation to nuclear grade, Endometrial carcinoma is staged surgically. Routine screening for endometrial carcinoma in women taking tamoxifen is not recommended. A primary endometrioid adenocarcinoma of the endometrium that contains 6-50% non-squamous solid areas. Ma ...angina pectorala, suflu sistolic, tahicardie si diabet. Risk factors for increased hormone levels and endometrial adenocarcinoma include a family history of reproductive cancers, obesity, diabetes, and hormone therapy treatments for other conditions. The prognosis of endometrial carcinoma depends on various pathological factors such as histologic subtype, tumor grade (G1, G2, G3), and depth of myometrial invasion, which correlates strongly with the risk of lymph node metastasis and the patient's prognosis. LGESS frequently affects premenopausal women. Secondo la classificazione più usata, chiamata FIGO, i gradi di tumore dell'endometrio sono 3: G1, G2, G3. An endometrial thickness of 5 mm is the upper limit of normal in postmenopausal women without hormone replacement, although endometrial thickening is a somewhat nonspecific finding.64,65, Anuja Jhingran, Patricia J. Eifel, in Radiation Oncology (Ninth Edition), 2010. among 841 clinical stage I endometrial cancer patients with special reference to uterine papillary serous carcinoma.Gynecol Oncol. Type II endometrial carcinomas, by contrast, often arise from an atrophic endometrium. The lifetime risk for developing endometrial carcinoma for HNPCC gene carriers may be as high as 30%. they never mentioned my uterine fibroid i have. It has not spread to nearby lymph nodes (N0) or to distant sites (M0). @Iluviaporos - I had a sister who had endometrial cancer and she only discovered it through her pap smear at a family planning clinic. A background of endometrial hyperplasia is often found and should be noted when present. Subscribe to our newsletter and learn something new every day. But, it only takes a half hour out of your day and it can save your life. Dr. John Berryman answered. Other histologic types, such as papillary serous and clear cell carcinomas, which are associated with a more aggressive behavior than endometrioid carcinomas, account for 5% to 10% of endometrial cancers. Estrogen regulates the growth and health of endometrial tissue in women. Adenocarcinoma can also cause milky vaginal discharge in women of any age. These rare types of endometrial carcinoma include mucinous adenocarcinoma, secretory adenocarcinoma, and transitional cell carcinoma. Introduction. Under estrogenic influence the endometrium proliferates and the glandular epithelium becomes pseudostratified. For a tumor to be labeled “adenocarcinoma with squamous differentiation,” at least 10% of the tumor must show squamous differentiation. These kinds of conditions are the reason the family planning clinics are so very important. Peripheral conversion of androstenedione to estrone by the fibroblasts in the fat accounts for the increased risk. diagnosed well differentiated endometrial adenocarcinoma figo1and tvus says significant thickening with hyperechoic nodule directly adjacent to endometrial cavity. The present report, based on findings from one institution, notes that women 40 years of age or younger comprised 14.4% of the 111 patients with adenocarcinoma of the endometrium. An Oversimplified View of Endometrial Adenocarcinoma: Types 1 and 2. DWI can clearly demonstrate the boundary between hyperintense endometrial carcinoma and hypointense myometrium (Figures 8 and 9; Lin et al., 2009; Rechichi et al., 2010; Takeuchi et al., 2009a). The tumor shows very high SI with decreased ADC on DWI. Endometrial carcinoma is the most common gynaecological malignancy, with peak incidence at around the 6thdecade, though 12% of cases present in premenopausal women. Type II carcinomas are commonly high grade, deeply invasive, and of the serous, clear cell, or high-grade endometrioid with squamous differentiation (adenosquamous) type. The histopathologic grade of endometrial carcinoma is so important prognostically that grade is part of the staging classification (see “Staging”). Pap smears are NOT diagnostic tests for endometrial adenocarcinoma! ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. Figure 9. The exact causes of this kind of adenocarcinoma are not well understood, but doctors believe that high levels of estrogen, hypertension, and obesity are significant risk factors. Unless the cancer has already spread past the body of the uterus and the cervical canal, there is very little chance a pap smear will find them. It occurs in women older than those who develop type I. Other symptoms include pain with urination, pain during sexual intercourse, or pelvic pain. Scott M. Boles, ... Philip Rubin, in Oncologic Imaging, 2002. Obesity, nulliparity, tamoxifen therapy, long-term unopposed estrogen action, genetic predisposition, and hyperinsulinemia are supposed to be risk factors associated with it.… Near the fundus, the endometrial–myometrial junction is indistinct, indicating myometrial invasion (arrow). From the clinical point of view, endometrial carcinoma has been traditionally divided into two main categories: type I and type II. However, the assignment of the histopathologic grade, especially the distinction between grades 1 and 2, varies among pathologists. The first is along the uterine vessels into the internal iliac chain.57 In the second, the lymphatics from the uterine fundus travel with the ovarian vessels and empty directly into the high paraaortic lymph nodes. African American women have significantly higher rates of endometrial carcinomas with poor prognostic cell types, such as serous or clear cell carcinoma or carcinosarcoma. It is recommended that, starting at age 30, women from HNPCC families undergo annual endometrial sampling.12 These women should also undergo a colonoscopy every 2 years from age 20 to 35 and annually thereafter. The most common diagnostic tool for finding endometrial adenocarcinoma is an endometrial biopsy. Most endometrial cancers are adenocarcinomas, and endometrioid cancer is the most common type of adenocarcinoma, by far. It has not spread to nearby lymph nodes (N0) or to distant sites (M0). Type II carcinoma, accounting for 10% to 15% of cases, is more common in postmenopausal women and is generally not associated with a history of unopposed exposure to estrogen. I know it seems really uncomfortable and may seem like a particularly annoying procedure to go through once you've passed menopause and you feel like issues with that area should be over with. However, in limited samples, UPSCs may appear as uniform enlarged glands with stratified hyperchromatic nuclei. Chiaramente, i tumori G1 hanno la prognosi migliore. Type I are estrogen-induced, well-differentiated, superficially invasive tumors. The endometrioid adenocarcinomas can have areas of squamous metaplasia (adenoacanthoma) or areas of squamous carcinoma (adenosquamous carcinoma). The disease extends to the upper third of the vagina (white arrow). This is why it is imperative women experiencing any abnormal bleeding or pain that last for more than two weeks see their doctors. In cases of endometrial carcinoma limited to the endometrium or to invasion of the inner half of the myometrium (FIGO stage IA diseases), <3% of patients have nodal metastasis, whereas 46% of endometrial carcinomas with deep myometrial invasion (stage IB or higher) have nodal metastasis. There is NO routine "well woman" screening to determine endometrial adenocarcinoma. There are two major types of endometrial carcinoma, with distinctly different epidemiologic and histolopathologic features and prognoses (Table 37-2).62,63 Type I, accounting for 80% to 85% of all cases, is seen most often in pre- and perimenopausal women. Subtypes of sarcomas include carcinosarcomas, endometrial stromal tumors, leiomyosarcomas, and adenosarcomas. Endometrial carcinoma is the most common gynecologic malignancy .Although it can occur in younger women, more than 80% is seen in postmenopausal (PMP) women .In premenopausal and perimenopausal women, the most common type (and almost the exclusive type) of endometrial carcinoma is endometrioid adenocarcinoma (EMCA) with or without mucinous and … It is so important to get a regular pap smear. About 50% to 60% of cases of endometrial adenocarcinoma show some squamous differentiation. The mean age for patients with cervical adenocarcinoma in situ (AIS)/adenocarci-noma and endometrial adenocarcinoma in the con-ventional Pap control group was 40.7 and 59.4 years, respectively. Endometrial carcinoma is staged surgically. pT1C pNX M=8380/3 In prezent, face toate procedurile la Institutul Oncologic din Bucuresti. The clinician should be suspicious for UPSC if the nuclear features of the glands exceed that normally associated with EIN. moderately differentiated endometrial adenocarcinoma (International Federation of Gynecology and Obstetrics stage IA and grades G1 and G2) after dilatation and curettage (D&C) for a spontaneous abortion. Bleeding post-menopause is never normal, and that alone will alert your gyn to the need for a biopsy (and possibly ultrasound.) They include papillary serous carcinomas and clear cell carcinomas, are estrogen independent, and have a less favorable prognosis. In the United States, there is a greater incidence among patients of European descent compared those of African American descent. 17.31B), MICHAEL PETERSON, ... NOEL WEIDNER, in Modern Surgical Pathology (Second Edition), 2009, Endometrial carcinoma is a primary malignant epithelial tumor, usually with glandular differentiation, arising in the endometrium with the potential to invade and metastasize. Chemotherapy and radiation therapy are seldom used because they are generally less effective at eliminating this type of cancer. Type I tumors, which account for 80 % of endometrial carcinomas, are associated with a hyperplastic endometrium, and area associated with unopposed estrogen stimulation.

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