[When cancer of the endometrium is not a good cancer]

Two groups of endometrial carcinomas (EC) are described: group 1 with associated adenomatous hyperplasia (AH) and group 2 without. Group 1 tumors are better differentiated, less invasive and almost never metastasize. Histologically, they are mostly glandular and well differentiated. Stromal foam cells were often present supporting the association with hyperestrogenism. Progesterone receptors (PR) were present in all tested cases, and their levels were high. The patients were often obese, nulliparous and had histories of estrogen intake; group 2 are less well or poorly differentiated EC, showed papillary, clear cell and anaplastic patterns, often invaded the myometrium and metastasized. PR were present in less than half of the examined cases, at low levels. The patients in this group were rarely obese, often multiparous had no history of estrogen intake; they were older than those in group 1. None of the patients of group 1 died of the disease, while about one fourth of the patients of group 2 died of EC. It was concluded that EC with no associated AH, therefore not hormonally "dependent" are cancers of higher virulence.