ENDOMETRIAL CANCER IN OBSTETRICS AND GYNAECOLOGY

cancer endometrium

1. ENDOMETRIAL CANCER Endometrial carcinoma is the third commonest gynecologic malignancy, cancer of the cervix and ovary being the first two. Relatively low malignant potential of the tumor and early presentation in postmenopausal women account for the lower mortality.

2. CLINICAL FEATURES Asymptomatic in under 5% of cases. Abnormal bleeding: Postmenopausal, menorrhagia, post-coital spotting, intermenstrual. Blood-stained vaginal discharge. With cervical stenosis: hematometra, pyometra, purulent discharge. Colicky abdominal pain.

3. DIAGNOSIS Patient history and physical examination. Complete Blood Count (CBC) to assess hematologic status. Transvaginal ultrasound to evaluate endometrial thickness Endometrial biopsy for histopathological confirmation. Hysteroscopy combined with biopsy - diagnostic gold standard .

4. Pelvic assessment: Speculum Inspection: Cervix appears normal; blood or pus-like discharge from the external os . Bimanual Palpation: The uterus can present as atrophic, normal size, or enlarged, mobile except in advanced stages.

5. TRANSVAGINAL USG ENDOMETRIAL THICKNESS > 5 MM HYPER ECHOGENIC ENDOMETRIUM WITH IRREGULAR OUTLINE INCREASED VASCULARITY WITH LOW VASCULAR RESISTANCE INTRA UTERINE FLUID

6. HISTOPATHOLOGY

7. MRI

8. MODES OF SPREAD Direct invasion from the primary tumor (MC) Through the lymphatic system Via the fallopian tubes ( transtubal route) Bloodborne dissemination, commonly to the lungs

9. UTERINE SARCOMS Uterine sarcoma is a rare type of cancer that starts in the muscles and connective tissues of the uterus. There are three main types: endometrial stromal sarcoma, undifferentiated sarcoma, and uterine leiomyosarcoma

10. Sarcomas are cancers that start from tissues such as muscle, fat, bone,and fibrous tissue (the material that forms tendons and ligaments). • Uterine sarcoma is a cancer of the muscle and supporting tissues of theuterus