[Endometrial carcinoma and their precursors]

Endometrial carcinoma is significantly linked to the excess of exogenous and endogenous estrogens, non-tempered by progesterone. It is the second cancer in women after breast cancer. It is still detected with difficulty at the pre-invasive stage. Evaluation of its histological grade during the diagnosis (aspiration, curettage) influences the treatment. Grade I (80 p. cent of the cases) includes common carcinomas and their mucinous variants, with malpighian metaplasia, cytologically benign. Grade II concerns poorly differentiated carcinomas. Grade III concerns adeno squamous, anaplastic, seropapillar and clear cells carcinomas. The invasive stage, established on the operative specimen, represent the main prognostic factor. The risks of recurrence or metastases are practically non-existent when the carcinoma is localized to the endometrium, very low if the carcinoma invades a few mm of the myometrium, moderate if the medial half is involved, much higher if the invasion exceeds half of the thickness of the myometrium and/or involves the cervix.