Endometrial carcinoma in young women. A report of four cases

Endometrial carcinoma in young women is a rare but well-documented clinicopathologic entity. Four cases revealed some unusual clinical and pathologic features. Patient 1 was the first recorded case of a young woman (aged 24) on maintenance peritoneal dialysis for chronic renal failure who developed endometrial carcinoma with nonvirilizing oligoovulatory polycystic ovarian enlargement. Following subtotal proctocolectomy for familial polyposis coli complicated by a colonic and rectal carcinoma, patient 2 developed, at age 24, a grade 3 endometrial carcinoma in the absence of any risk factors; she was still alive three years postoperatively despite the subsequent development of a grade 3 astrocytoma in the left temporal region. Patient 3 presented at age 32 after ten years of amenorrhea with the clinical features of the Stein-Leventhal syndrome and abnormal uterine bleeding related to a grade 1 endometrial carcinoma; she also had focal dysplasia and adenocarcinoma in situ of the endocervix. Patient 4, who had no risk factors, developed a grade 2 endometrial carcinoma at age 34 despite constant use of combined oral contraceptives for one year and intermittent exposure to them for the previous ten years. Endometrial carcinoma is a rare but important cause of abnormal uterine bleeding in young women; the prognosis can be improved only by prompt diagnosis and appropriate therapy.