ENDOMETRIAL CARCINOMA IN WOMEN 40 YEARS OF AGE OR YOUNGER

  • 1 January 1981
    • journal article
    • research article
    • Vol. 57  (6) , 699-704
Abstract
Adenocarcinoma of the endometrium in patients 40 yr of age or younger is rare and accounts for 2.9% of all endometrial cancers diagnosed in the study community. The diagnosis of malignancy was confirmed in only 32 of 54 patients (59.2%) with pathologic material available for review. None of the 32 patients had Stein-Leventhal syndrome or was receiving sequential oral contraceptives. Obesity was found in only 37.5%, nulligravidity in 37.5%, and hypertension in 25%. In 81%, the presenting symptom was abnormal vaginal bleeding, and 6 patients (19%) had coexisting ovarian neoplasms (4 endometrioid carcinomas, 1 mucinous cystadenocarcinoma, and 1 adenocarcinoma arising in a cystic teratoma). Atypical endometrial hyperplasia, previously interpreted as well-differentiated adenocarcinoma, was diagnosed in 11 of 22 patients. The pathologic criteria for establishing a diagnosis of atypical endometrial hyperplasia and distinguishing it from well-differentiated adenocarcinoma of the endometrium are emphasized. Of 32 patients, 13 received no radiation therapy and none developed pelvic recurrence or metastatic tumor. The 2 deaths from tumor were in patients with stage 3 ovarian cancer, and no patients died of endometrial carcinoma. The current policy is to treat patients with typical endometrial hyperplasia and well-differentiated adenocarcinoma (clinical stage I, pathology confimred) by hysterectomy without irradiation treatment. Because 6 of the 32 patients (19%) had coexisting ovarian neoplasms, careful examination of the adnexa at the time of clinical staging is emphasized.