Adenocarcinoma of the endometrium associated with intrauterine pregnancy

A case of adenocarcinoma of the endometrium discovered during curettage of inevitable abortion is described and seven instances with the association of fundal cancer and intrauterine pregnancy are reviewed. In half of the eight patients including the present case, a complication of pregnancy led to the discovery of the tumor; in the remaining four instances, the gestation occurred incidentally in a patient known to have a fundal cancer. All the seven neoplasms previously reported were well-differentiated, minimally or noninvasive adenocarcinoma or adenoacanthoma, while the tumor of the present case was moderately differentiated adenocarcinoma which invaded into about one-half of the myometrium. Progesterone-induced histologic findings, such as secretory differentiation of glands, mitotic arrest, and decidual reaction of stromal cells, were not noted. Prognosis of the patients with this association seems to be good. Follow-up on five of the seven previously reported cases indicates that four are well more than 5 years. The present patient is also well more than 5 years after hysterectomy and pelvic irradiation therapy. There is only one patient who has died of recurrence 3 years after definitive therapy.