Aggressive mixed type endometrial carcinoma in a young woman with rapid progression and fatal outcome

Endometrial carcinoma in young ages is uncommon and tends to be a well differentiated endometrioid type and has an excellent prognosis. Nevertheless, in this report mixed type endometrial cancer including serous, clear cell and endometrioid components in a young patient with rapid progression and fatal outcome is presented.

A 26-year-old virgin female was admitted with menometrohagia lasting for 9 months, leading to severe anemia. Transabdominal ultrasonography demonstrated 30 x 27 mm intramural mass consistent with leiomyoma in uterine corpus posterior. The patient did not permit any vaginal intervention including endometrial sampling, therefore laparotomy was decided. Mixed type endometrial carcinoma was diagnosed and she was treated with comprehensive surgery plus adjuvant chemotherapy. After 7 months of surgery she deceased.

We suggest that persistent uterine bleeding associated with severe anemia should be evaluated for malignancy even in young women to avoid delay in diagnosis. Imaging studies especially magnetic resonance imaging may be helpful when endometrial sampling cannot be done.