Cancer of the body of the uterus or endometrial cancer
Cancer of the body of the uterus or endometrial cancer
It affects 10 to 40 women per 100 000. Most often it is a carcinoma (cancer of the endothelium). Note that there is currently no recognized test of this type of cancer.
Risk factors:
-family history of endometrial cancer- personal or family history of breast, colon or ovarian cancer ...-estrogen exposure: nulliparity (the fact of not having had children), early puberty, late menopause, obesity, hormone replacement therapy, polycystic ovary syndrome, hormone therapy with tamoxifen, etc. ...-hypertension and diabetes mellitus
The clinical signs of disease :
The major symptom is uterine bleeding (metrorrhagia), isolated and spontaneous, for a woman who no longer has her periods as she is post-menopausal.The diagnosis is more difficult when the bleeding affects a woman who is still more or less settled around menopause, it may be menorrhagia (heavier periods) or bleeding outside of menstrual cycle. Before the bleeding, direct examination with a speculum and Pap smears, colposcopy, generally show a normal cervix. Pelvic examinations (vaginal and rectal examinations) are usually normal.
Examinations and further tests:
-The ultrasound shows an abnormal increase in the thickness of the uterine lining and can assess the degree of infiltration of myometrium.-Hysteroscopy may show typical images, specifying the extension and the location of the lesions.-Curettage or biopsy allow for diagnosis.Other tests are useful for staging: pelvic MRI in particular.
Differential diagnoses: :
Cancer of the uterine corpus is the first case to look for in a postmenopausal woman who has uterine bleeding. Only after having eliminated this diagnosis can other hypotheses be raised: vaginitis, bleeding due to estrogens, etc. ...
The prognosis:
When the diagnosis is early enough, recovery is usual.The prognostic factors are:-the high age of the patient-the visceral defects-cancer stage III and IV according to FIGO classification-histological type-the node
Treatment:
The treatment involves surgical removal of the uterus and annexes, ovaries and fallopian tubes (hysterectomy with oophorectomy), lymphadenectomy (resection of nodes) supplemented by brachytherapy (establishment of radioactive products in contact of the tumor) or external beam radiotherapy.
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