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endometrial carcinoma

Description

Endometrial Carcinoma: A Comprehensive Overview

Endometrial carcinoma, also known as endometrial cancer, is a type of cancer that begins in the lining of the uterus (endometrium). It is the most common type of cancer affecting the female reproductive system.

  • Types of Endometrial Cancer: Endometrial carcinomas can be divided into different types based on how the cells look under the microscope. The two main types are:
    • Type I: Non-aggressive tumors that are usually estrogen-responsive and are more common in women with obesity and at younger ages (perimenopause or early in menopause) [14][15].
    • Type II: More aggressive tumors that are less common and often diagnosed in older women [14][15].
  • Symptoms: Abnormal uterine bleeding is the cardinal symptom of endometrial cancer. This can include vaginal bleeding between periods or after menopause [5]. A minority of patients may also present with abnormal findings on cervical cytology.
  • Incidence and Mortality: Endometrial cancer is the most common female genital cancer in the developed world, with over 66,000 new cases diagnosed each year in the United States alone [6][11].
  • Treatment: Endometrial cancer can be treated with surgery, especially when diagnosed at an early stage. The prognosis and treatment options vary depending on the stage of the disease [12].

References:

[1] Context result 3 [2] Context result 5 [3] Context result 14 [4] Context result 15

Additional Characteristics

  • Abnormal uterine bleeding
  • Endometrial carcinoma
  • Type I endometrial cancer
  • Type II endometrial cancer
  • Estrogen-responsive tumors

Signs and Symptoms

Based on the context, here are the signs and symptoms of endometrial carcinoma:

  1. Abnormal vaginal bleeding: This is the most common symptom of endometrial cancer, including:
    • Vaginal bleeding between periods
    • Bleeding after menopause
    • Changes in bleeding before menopause
  2. Pelvic pain: Pain in the pelvic area can be a symptom of endometrial cancer.
  3. Unexplained weight loss: Some women with endometrial cancer may experience unexplained weight loss.
  4. Watery vaginal discharge: A watery, pink, or white vaginal discharge can be a symptom of endometrial cancer.
  5. Pain during sex: Painful intercourse (dyspareunia) can be a symptom of endometrial cancer.
  6. Pelvic mass: In advanced stages, a pelvic mass (tumor) may be palpable.

It's essential to note that these symptoms do not always mean you have endometrial carcinoma. If you experience any of these symptoms, it's crucial to consult with your healthcare provider for proper evaluation and diagnosis.

Additional Symptoms

Diagnostic Tests

Diagnostic Tests for Endometrial Carcinoma

Endometrial carcinoma, also known as endometrial cancer, can be diagnosed using various diagnostic tests. These tests help determine the extent of the tumor and whether it has spread to other parts of the body.

  • Endometrial Biopsy: A thin flexible tube is inserted through the cervix into the uterus to collect a tissue sample for examination under a microscope.
  • Hysteroscopy: A procedure where a small camera is inserted through the cervix to visualize the inside of the uterus and take a biopsy.
  • Ultrasound: An imaging test that uses sound waves to create images of the uterus, helping to detect any abnormalities or tumors.
  • CA 125 Blood Test: Measures the level of CA 125 protein in the blood, which can be elevated in some cases of endometrial cancer.

Staging and Diagnosis

The stage of endometrial cancer is determined by examining information from exams and diagnostic tests. The staging system helps determine the best treatment plan and prognosis for the patient.

  • Endometrial Tissue Sampling: A definitive diagnosis of endometrial cancer requires an endometrial tissue sample, which can be obtained through curettage or Pipelle sampling.
  • Clinical Trials: Researchers are studying new diagnostic tests and treatments for endometrial cancer in clinical trials.

References

  1. [4] The definitive diagnosis of endometrial cancer requires an endometrial tissue sample.
  2. [8] Blood tests can help diagnose, stage, and determine how to treat uterine cancer.
  3. [11] Tests for Endometrial Cancer; Stages and Outlook (Prognosis) After a cancer diagnosis, staging provides important information about the amount of cancer in the body, the best treatment options, and the likely response to treatment.

Note: The numbers in square brackets refer to the context search results used to generate this answer.

Treatment

Treatment Options for Endometrial Carcinoma

Endometrial carcinoma, also known as endometrial cancer, can be treated with various drug therapies, depending on the stage and type of cancer.

  • Chemotherapy: Chemotherapy uses strong medicines to kill cancer cells. Some people receive one chemotherapy medicine, while others receive two or more medicines in combination (see [8] and [11]). Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing ([14]).
  • Targeted Therapy: Targeted therapy uses medications that specifically target cancer cells. For example, dostarlimab-gxly (Jemperli) has been approved for use with chemotherapy to treat people with endometrial cancer ([9] and [12]). Dostarlimab can treat advanced or recurrent dMMR endometrial cancer that has gotten worse after receiving carboplatin or cisplatin ([4]).
  • Immunotherapy: Immunotherapy uses medications that stimulate the immune system to fight cancer. Nivolumab (Opdivo) may be used by itself to treat advanced or recurrent endometrial cancer that is dMMR/MSI-H ([5]). Dostarlimab (Jemperli), another immunotherapy drug, received accelerated FDA approval in 2021 for recurrent or advanced endometrial cancer that is mismatch-repair deficient (dMMR) and has progressed on or after a platinum-containing regimen ([15]).
  • Hormone Therapy: Hormone therapy uses medications to block hormones that can fuel the growth of cancer cells. However, hormone therapy is not usually used to treat endometrial cancer ([14]).

Newly Approved Treatments

In recent years, several new treatments have been approved for use in treating endometrial carcinoma:

  • Dostarlimab-gxly (Jemperli) was recently approved for the treatment of endometrial cancer. It can be used with chemotherapy to treat people with newly diagnosed endometrial cancer that has spread or cancer that has come back after earlier treatment ([9] and [12]).
  • Pembrolizumab 200 mg every 3 weeks, paclitaxel 175 mg/m^2 and carboplatin AUC 5 mg/mL/min for 6 cycles, followed by pembrolizumab alone was approved in combination with chemotherapy to treat people with endometrial cancer ([13]).

References

[4] Dostarlimab can treat advanced or recurrent dMMR endometrial cancer that has gotten worse after receiving carboplatin or cisplatin. [8] Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing. [9] Dostarlimab-gxly (Jemperli) was recently approved for the treatment of endometrial cancer. [11] Chemotherapy uses strong medicines to kill cancer cells. [12] Dostarlimab can be used with chemotherapy to treat people with newly diagnosed endometrial cancer that has spread or cancer that has come back after earlier treatment. [13] Pembrolizumab 200 mg every 3 weeks, paclitaxel 175 mg/m^2 and carboplatin AUC 5 mg/mL/min for 6 cycles, followed by pembrolizumab alone was approved in combination with chemotherapy to treat people with endometrial cancer. [14] Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing. [15] Dostarlimab (Jemperli), another immunotherapy drug, received accelerated FDA approval in 2021 for recurrent or advanced endometrial cancer that is mismatch-repair deficient (dMMR) and has progressed on or after a platinum-containing regimen.

Recommended Medications

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Differential Diagnosis

Differential Diagnosis of Endometrial Carcinoma

Endometrial carcinoma, also known as uterine cancer, requires a thorough differential diagnosis to rule out other conditions that may present with similar symptoms or characteristics.

Key Differential Diagnoses:

  • Benign endometrial proliferation: This includes conditions such as endometrial hyperplasia and polyps, which can cause abnormal uterine bleeding and endometrial thickening.
  • Endometrial hyperplasia: A condition characterized by an overgrowth of the endometrium, which can be a precursor to endometrial carcinoma.
  • Submucosal uterine leiomyoma: A type of benign tumor that can cause abnormal uterine bleeding and endometrial thickening.
  • Endometritis unrelated to pregnancy: An inflammation of the endometrium that can mimic the symptoms of endometrial carcinoma.

Other Differential Diagnoses:

  • Grade 3 endometrioid carcinoma: A type of endometrial cancer with a high grade of differentiation, which can be difficult to distinguish from undifferentiated carcinoma.
  • Serous carcinoma with solid architecture: A type of endometrial cancer that can present with a solid architecture, making it challenging to differentiate from other types of carcinomas.
  • Lymphoma, plasmacytoma, melanoma, high-grade endometrial stromal sarcoma, and high-grade neuroendocrine carcinoma: These are rare conditions that can mimic the symptoms of endometrial carcinoma.

Diagnostic Evaluation:

The definitive diagnosis of endometrial cancer requires an endometrial tissue sample. Curettage has been considered the preferred method for obtaining a tissue sample, but the newer Pipelle technique is also used. A thorough diagnostic evaluation, including histologic evaluation and other laboratory and imaging studies, is necessary to exclude differential diagnoses and guide preoperative staging.

References:

  • [1] ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up (Ann Oncol. 2016)
  • [2] Application of clonal analysis (Differential diagnosis for synchronous primary ovarian and endometrial cancers) (Gynecol Oncol. 2004)
  • [3] Evaluation of the endometrium is the key component in the diagnostic evaluation of patients suspected of endometrial carcinoma or other conditions affecting the uterus (Am J Obstet Gynecol. 2018)

Note: The references provided are a selection of relevant studies and guidelines that support the information presented above.

Additional Information

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It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with questions about your medical condition.