Histopathological features of endometrial carcinoma

To evaluate and compare the histopathological features of endometrial carcinoma among women of various age groups.

Descriptive study.

The study was conducted at The Aga Khan University Hospital, Histopathology Department, from January 2001--December 2003.

All cases of endometrial carcinoma who underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy were included.

Median age was 55 years. Bleeding per vaginum was the commonest feature and endometrioid adenocarcinoma was the commonest histological type. Tumor involved < and > half of the myometrium in nearly half of the patients each. Vascular invasion, endocervical invasion and adnexal involvement were evident in a small number of cases. Amongst the 86 patients majority were well differentiated (grade-1) and stage-1, on FIGO staging. Patients (<40 years) had endometrioid type of endometrial carcinoma, grade-1, and FIGO stage-1. In 85% tumor was invading to < half of myometrium. Significant difference was seen among the 40--49 and >50 years age groups in grade and depth of myometrial invasion. As 76% were grade-1, 80% had myometrial invasion < half in patients <50 years, while 43.6% were grade-I and 41.8% had myometrial invasion >half in patients >50 years.

Patients with endometrial carcinoma presented in early stage (stage-1) and tumor well differentiated (grade-1). In patients of more than 50 years of age even with stage-1, an increased frequency of deep myometrial invasion and less differentiated tumors, adnexal involvement, endocervical invasion, positive peritoneal cytology, vascular invasion and lymph nodes metastasis found.