Preinvasive Lesions in Gynaecology – Endometrium

Czech version

Authors: R. Feranec; L. Mouková; J. Chovanec
Authors‘ workplace: Oddělení gynekologické onkologie, Masarykův onkologický ústav, Brno
Published in: Klin Onkol 2013; 26(Supplementum): 52-53

Overview

Preinvasive lesions of the endometrium are histopathological and molecular alterations related to high-risk of uterine carcinoma development. Incidence has increasing tendency. Atypical endometrial hyperplasia is the preinvasive lesion of type I endometrial carcinoma, developing under a hyperestrogenic background. Carcinoma in situ of the endometrium is considered to be precursor lesion of type II endometrial carcinoma, first of all uterine serous carcinoma. Hysterectomy and bilateral oophorectomy is the main therapeutical modality in both preinvasive lesions of the endometrium. The hormonal therapy with progestogens is the possibility of fertility sparing approach in treatment of histological findings of atypical endometrial hyperplasia in young women. Even though preinvasive lesions of the endometrium are clearly defined, the possibilities of endometrial cancer screening are markedly limited.

Key words:
preinvasive lesion – endometrium – atypic endometrial hyperplasia – carcinoma in situ of the endometrium

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Submitted:
11. 9. 2013

Accepted:
9. 10. 2013

Sources

1. ÚZIS, Národní onkologický registr ČR. Incidence a mortalita vybraných diagnóz ZN. In: Novotvary. Praha: ÚZIS 2009: 30.

2. Creasman WT, Odicino F, Maisonneuve P. Carcinoma of the corpus uteri. Int J Gynaecol Obstet 2003; 83 (Suppl 1): 79– 118.

3. Bokhmann JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol 1983; 15(1): 7– 10.

4. Lax SF. Molecular genetic pathways in various types of endometrial carcinoma: from a phenotypical to a molecular‑based classification. Virchows Arch 2004; 444(3): 213– 223.

5. Berman JJ, Albores– Saavedra J, Bostwick D et al. Precancer: a conceptual working definition results of a Consensus Conference. Cancer Detect Prev 2006; 30(5): 387– 394.

6. Mutter GL. Histopathology of genetically defined endometrial precancers. Int J Gynecol Pathol 2000; 19(4): 301– 309.

7. Mutter GL, Zaino RJ, Baak JP. Benign endometrial hyperplasia sequence and endometrial intraepithelial neoplasia. Int J Gynecol Pathol 2007; 26(2): 103– 114.

8. Zheng W, Schwartz PE. Serous EIC as an early form of uterine papillary serous carcinoma: recent progress in understanding its pathogenesis and current opinions regarding pathologic and clinical management. Gynecol Oncol 2005; 96(3): 579– 582.

9. Pluta M. Patogeneze a management prekanceróz endometria. Prakt Gyn 2004; (2): 6– 7.

10. Burke W, Petersen G, Lynch P et al. Recommendation for follow‑up care of individuals with an inherited predisposition to cancer. I. Hereditary nonpolyposis colon cancer. Cancer Genetics Studies Consortium. JAMA 1997; 277(11): 915– 919.

11. Langer RD, Pierce JJ, O’Hanlan KA et al. Transvaginal ultrasonography compared with endometrial biopsy for the detection of endometrial disease. Postmenopausal Estrogen/ Progestin Interventions Trial. N Engl J Med 1997; 337(25): 1792– 1798.

12. Gull B, Karlsson B, Milsom I et al. Can ultrasound replace dilation and curettage? A longitudinal evaluation of postmenopausal bleeding and transvaginal sonographic measurement of the endometrium as predictors of endometrial cancer. Am J Obstet Gynecol 2003; 188(2): 401– 408.

13. Fung MF, Reid A, Faught W et al. Prospective longitudinal study of ultrasound screening for endometrial abnormalities in women with breast cancer receiving tamoxifen. Gynecol Oncol 2003; 91(1): 154– 159.