Hysteroscopy to detect Stage IA well-differentiated endometrioid adenocarcinoma of the endometrium

2003 ◽  
Vol 82 (4) ◽  
pp. 378-384 ◽  
Author(s):  
Tadashi Iha ◽  
Hong Shen ◽  
Koji Kanazawa
Keyword(s):  
Endometrioid Adenocarcinoma ◽  
Stage Ia ◽  
Well Differentiated

Efficacy of Megestrol Acetate (Megace) in the Treatment of Patients With Early Endometrial Adenocarcinoma: Our Experiences With 21 Patients

2009 ◽  
Vol 19 (2) ◽  
pp. 249-252 ◽  
Author(s):  
Zahra Eftekhar ◽  
Narges Izadi-Mood ◽  
Fariba Yarandi ◽  
Hadi Shojaei ◽  
Zahra Rezaei ◽  
...  
Keyword(s):  
Therapeutic Response ◽  
Endometrial Adenocarcinoma ◽  
Initial Response ◽  
Response To Therapy ◽  
Megestrol Acetate ◽  
Dilatation And Curettage ◽  
Stage Ia ◽  
The Mean ◽  
Well Differentiated ◽  
A Prospective Study

Background:There are therapeutic dilemmas regarding fertility-preserving treatment among young women with well-differentiated endometrial carcinoma.Materials and Methods:Twenty-one patients with stage IA well-differentiated endometrial adenocarcinoma were enrolled in a prospective study. The treatment initiated with 160 mg/d of megestrol acetate. The patients underwent dilatation and curettage and hysteroscopy after 3 months, and in cases of normal pathology, the therapy continued for another 3-month period. In patients who did not respond to treatment, the dosage of the drug was doubled (320 mg/d), and the therapy continued for another 3 months. At the second time, patients who did not respond to treatment were recommended for hysterectomy, and in patients who responded to treatment, an additional 3 months of treatment with megestrol acetate (320 mg/d) was administered.Results:Our results showed a response rate of 85.71% (18 patients), and 3 patients underwent hysterectomy. The mean (SD) treatment duration was 8.85 (2.00) months (range, 6-12 months). The response to therapy was observed in 5 patients (27.78%) with a dosage of 160 mg/d, and the remaining patients with 320 mg/d. Pregnancy occurred in 5 patients (27.78%). Recurrence happened in 3 (16.67%) of 18 patients who responded to treatment who did not give a permit to undergo hysterectomy and received medication again. Two (66.67%) of these patients experienced remission again, whereas the other one was candidate for hysterectomy.Conclusions:The results of this study show that, when an initial response is not achieved or when disease recurs, use of 320 mg/d seems to be associated with a better therapeutic response. Furthermore, serious complications were not observed with this dosage.

scholarly journals Dedifferentiated Endometrial Carcinoma Could be A Target for Immune Checkpoint Inhibitors (Anti PD-1/PD-L1 Antibodies)

2019 ◽  
Vol 20 (15) ◽  
pp. 3744 ◽  
Author(s):  
Ruriko Ono ◽  
Kentaro Nakayama ◽  
Kohei Nakamura ◽  
Hitomi Yamashita ◽  
Tomoka Ishibashi ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Tumor Infiltrating Lymphocytes ◽  
Undifferentiated Carcinoma ◽  
Endometrioid Adenocarcinoma ◽  
Mmr Deficiency ◽  
Well Differentiated ◽  
Mmr Proteins

Dedifferentiated endometrial carcinoma (DDEC) is defined as an undifferentiated carcinoma admixed with differentiated endometrioid carcinoma (Grade 1 or 2). It has poor prognosis compared with Grade 3 endometrioid adenocarcinoma and is often associated with the loss of mismatch repair (MMR) proteins, which is seen in microsatellite instability (MSI)-type endometrial cancer. Recent studies have shown that the effectiveness of immune checkpoint inhibitor therapy is related to MMR deficiency; therefore, we analyzed the immunophenotype (MMR deficient and expression of PD-L1) of 17 DDEC cases. In the undifferentiated component, nine cases (53%) were deficient in MMR proteins and nine cases (53%) expressed PD-L1. PD-L1 expression was significantly associated with MMR deficiency (p = 0.026). In addition, the presence of tumor-infiltrating lymphocytes (CD8+) was significantly associated with MMR deficiency (p = 0.026). In contrast, none of the cases showed PD-L1 expression in the well-differentiated component. Our results show that DDEC could be a target for immune checkpoint inhibitors (anti PD-L1/PD-1 antibodies), especially in the undifferentiated component. As a treatment strategy for DDEC, conventional paclitaxel plus carboplatin and cisplatin plus doxorubicin therapies are effective for those with the well-differentiated component. However, by using immune checkpoint inhibitors in combination with other conventional treatments, it may be possible to control the undifferentiated component and improve prognosis.

L-type Amino Acid Transporter 1 Expression Increases in Well-Differentiated but Decreases in Poorly Differentiated Endometrial Endometrioid Adenocarcinoma and Shows an Inverse Correlation With p53 Expression

2014 ◽  
Vol 24 (4) ◽  
pp. 659-663 ◽  
Author(s):  
Jun Watanabe ◽  
Yoshihito Yokoyama ◽  
Masayuki Futagami ◽  
Hideki Mizunuma ◽  
Haruhiko Yoshioka ◽  
...  
Keyword(s):  
Estrogen Receptor ◽  
Prognostic Factor ◽  
Atypical Hyperplasia ◽  
Endometrioid Adenocarcinoma ◽  
Ki 67 ◽  
P53 Expression ◽  
Proliferative Phase ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
Endometrial Endometrioid Adenocarcinoma

ObjectivesThe aims of this study were to determine whether the altered L-type amino acid transporter 1 (LAT1) expression is related to clinicopathologic factors, expressions of Ki-67, p53, estrogen receptor, and progesterone receptor and clarify the significance of LAT1 as a prognostic factor and the novel possibility of using it to treat endometrial endometrioid adenocarcinoma.MethodsThe LAT1 expression was analyzed immunohistochemically in atrophic (6 cases), secretory phase (6 cases), proliferative phase endometria (6 cases), atypical hyperplasia (6 cases), and endometrioid adenocarcinoma (26 well-differentiated [G1], 17 moderately differentiated, and 11 poorly differentiated [G3] adenocarcinoma patients).ResultsThe LAT1 expression was observed in the cell membrane. Its expression increased in the atrophic, secretory, and proliferative phases of the endometrium in that order. There was no difference between the proliferative phase endometrium, atypical hyperplasia, and G1 adenocarcinoma. The LAT1 expression in G1 adenocarcinoma was significantly higher than that in G3 adenocarcinoma. The LAT1 expression was inversely correlated with p53 expression but not with those of Ki-67, estrogen receptor, or progesterone receptor.ConclusionsIt is suggested that the significance of LAT1 as a prognostic factor is low because LAT expression was low in G3 adenocarcinoma, not correlated with the International Federation of Gynecology and Obstetrics stage and proliferative activity and inversely correlated with p53. The LAT1 inhibitors can be used as anticancer drugs for G1 and moderately differentiated adenocarcinoma that express high LAT1.

scholarly journals Two cases of successful pregnancies after hysteroscopic removal of endometrioid adenocarcinoma grade I, stage IA, in young women with Lynch syndrome

2014 ◽  
Vol 15 (1) ◽  
pp. 63-66 ◽  
Author(s):  
Ingrid Marton ◽  
Hrvojka Soljacic Vranes ◽  
Vladimir Sparac ◽  
Igor Maricic ◽  
Krunoslav Kuna ◽  
...  
Keyword(s):  
Lynch Syndrome ◽  
Young Women ◽  
Endometrioid Adenocarcinoma ◽  
Stage Ia

scholarly journals Endometrioid Adenocarcinoma Arising in Adenomyoma in a Woman with a Genital Prolapse - Case Report

2018 ◽  
Vol 6 (6) ◽  
pp. 1091-1094 ◽  
Author(s):  
Vesna S. Antovska ◽  
Iskra Krstevska ◽  
Milka Trajanova ◽  
Jasmina Chelebieva ◽  
Irena Gosheva ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Clinical Symptoms ◽  
Endometrial Adenocarcinoma ◽  
Uterine Cavity ◽  
Genital Prolapse ◽  
Uterine Wall ◽  
Low Grade ◽  
Endometrioid Adenocarcinoma ◽  
Ultrasound Evaluation ◽  
Well Differentiated

BACKGROUND: Endometrial cancer is the third-ranked genital malignancy in women and includes 3% of cancer deaths. There is a 2.8% chance of a woman developing endometrial cancer during her lifetime. Low-grade endometrioid adenocarcinomas are often seen along with endometrial hyperplasia, but high-grade endometrioid adenocarcinomas have more solid sheets of less-differentiated tumour cells, which are no longer organised into glands, often associated with surrounded atrophic endometrium.CASE REPORT: We present an unusual case of endometrial adenocarcinoma arising in adenomyoma in 74-year old woman presented with genital prolapse, without other clinical symptoms. Ultrasound evaluation revealed endometrium with 4 mm-thickness and atrophic ovaries. The cervical smear was normal. The patient underwent a total vaginal hysterectomy. The histopathology of the anterior uterine wall revealed an intramural adenomyoma of 4 mm in which some endometrial glands with malignant transformation of well-differentiated endometrioid adenocarcinoma without infiltration in surrounding myometrium and lymphovascular invasion were present. The endometrium lining the uterine cavity was predominantly atrophic, and only one focus of simplex and complex hyperplasia was found, with cell-atypia. According to AJCC/FIGO 2010, the tumour was classified: pTNM = pT1B pNX pMX G1 R0 L0 V0 NG1, Stage I. On dismiss, the near-future oncological consultation was recommended.CONCLUSION: We would like to point out the rare occurrence of such type of malignancy and the importance of meticulous histopathology evaluation, even after reconstructive surgery for genital prolapse.

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