Histopathological features of endometrial carcinoma.

Objective: To evaluate and compare the histopathological features of endometrial carcinoma among women of various age groups.

Design: Descriptive study.

Place And Duration Of Study: The study was conducted at The Aga Khan University Hospital, Histopathology Department, from January 2001--December 2003.

Patients And Methods: All cases of endometrial carcinoma who underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy were included.

Results: Median age was 55 years. Bleeding per vaginum was the commonest feature and endometrioid adenocarcinoma was the commonest histological type. Tumor involved < and > half of the myometrium in nearly half of the patients each. Vascular invasion, endocervical invasion and adnexal involvement were evident in a small number of cases. Amongst the 86 patients majority were well differentiated (grade-1) and stage-1, on FIGO staging. Patients (<40 years) had endometrioid type of endometrial carcinoma, grade-1, and FIGO stage-1. In 85% tumor was invading to < half of myometrium. Significant difference was seen among the 40--49 and >50 years age groups in grade and depth of myometrial invasion. As 76% were grade-1, 80% had myometrial invasion < half in patients <50 years, while 43.6% were grade-I and 41.8% had myometrial invasion >half in patients >50 years.

Conclusion: Patients with endometrial carcinoma presented in early stage (stage-1) and tumor well differentiated (grade-1). In patients of more than 50 years of age even with stage-1, an increased frequency of deep myometrial invasion and less differentiated tumors, adnexal involvement, endocervical invasion, positive peritoneal cytology, vascular invasion and lymph nodes metastasis found.