1. Carcinoma Corpus Uteri
Max Brinsmead MB BS PhD
May 2015

2. Ca Endometrium – Burden of Illness
As common as cancer of cervix
1:100 lifetime risk
A disease of postmenopausal years
Fortunately, most present early

3. Ca Endometrium – Histological Types
Adenocarcinoma
Adenoacanthoma
Adenosquamous
Papillary carcinoma
Mixed Mullerian tumour
(Spreads via lymphatics, blood and directly to ovaries and cervix/vagina)

4. Ca Endometrium - Staging
Stage 1 – confined to body uterus
Stage 2 – spread to cervix
Stage 3 – beyond uterus but within pelvis
Spread to bladder/bowel or distant metastases

5. Ca Endometrium – Diagnosis 1
Typically presents as postmenopausal bleeding
However, only 10% with this symptom have Ca
Must consider the patient at risk i.e:
Nulliparous
Infertile
PCO syndrome
Late menopause
Obese/Hypertensive/Diabetic
E2 therapy
Genetic syndromes

6. Ca Endometrium – Diagnosis 2
Evaluation of the endometrium can be done by:
Pap smear
Vagina ultrasound – look at endometrial thickness
Saline hysterography – good for polyps
Endometrial sampling e.g. Pipelle
D&C
Hysteroscopy with fluid and biopsy is the gold standard
And there is argument about who should get what test
But this depends on the degree of risk

7. Ca Endometrium - Treatment
Hysterectomy – including ovaries and sampling nodes/ peritoneal wash
Radical hysterectomy if cervix involved
Preop or Postop radiotherapy
Progestin therapy

8. Ca Endometrium - Prognosis
Overall 60 – 80% but also depends on:
Stage
Differentiation
Depth of myometrial involvement
Node or peritoneal involvement
Hormone receptor status
Medical condition of the patient

9. Any Questions or Comments?
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