Pathologic Characteristics of Endometrial Carcinoma in Women 40 Years of Age and Younger.
Cora Uram-Tuculescu, Ema Dragoescu. Virginia Commonwealth University Health System, Richmond
Background: Endometrial carcinoma (EC) is the most common invasive gynecologic cancer. Arising mainly in postmenopausal women, it is uncommon before 40 years (y) of age. Previously considered to have favorable histology and excellent outcome, recent studies suggest that EC arising prior to age 40y (EC<40y) may have unfavorable histology and extrauterine disease. The etiology of EC<40y is considered to be primarily unopposed estrogen stimulation in the setting of obesity and anovulatory cycles with a smaller number of cases attributed to microsatellite instability (MSI) as an inherited risk factor. The aim of this series is to analyze the pathologic features of EC<40y in our academic center.
Design: All cases of EC<40y diagnosed at our center between January 2005 and September 2010 were retrieved and information from the pathology reports at the time of surgery was recorded. For patients who elected for uterine conservation/medical treatment, results from endometrial biopsy/curettage were used. Status of MSI, estrogen (ER) and progesterone (PR) by immunohistochemistry was retrieved. Body mass index (BMI) of each patient was recorded.
Results: 15 cases of EC<40 y were identified, representing 13.2% of all 113 EC diagnosed during this interval. Women ranged in age from 20 to 40y (mean=34.8). Table 1 summarizes the findings for 11 patients (73.3%) who had surgery.
|Histologic type||Total number of cases|
|FIGO histologic grade|
|II and III||8(72.7%)|
|Size of tumor|
|< 2.0 cm (0.3-0.7 cm)||3(27.3%)|
|> 2.0 cm (3.9-9.8 cm)||8(72.7%)|
|Pelvic washing cytology|