Summary
Definition
History and exam
Other diagnostic factors
- uterine mass, fixed uterus, or adnexal mass indicating extrauterine disease
- abnormal menstruation or vaginal bleeding in a premenopausal woman
- pain and weight loss
- symptoms of metastatic spread
- signs of metastatic spread
Risk factors
- obesity
- inactivity
- age >50 years
- endometrial hyperplasia
- unopposed endogenous estrogen
- unopposed exogenous estrogen
- tamoxifen use
- insulin resistance
- family history of endometrial cancer
- family history of breast cancer or ovarian cancer
- family history of hereditary nonpolyposis colon cancer (Lynch syndrome)
- family history of PTEN syndromes
- nulliparity and infertility
- polycystic ovary syndrome
- radiation therapy
- white ethnicity
Diagnostic investigations
1st investigations to order
- pelvic (transvaginal) ultrasound
- office endometrial biopsy and histopathology
- hysteroscopy, D&C and histopathology
- Pap smear
- CBC
Investigations to consider
- serum CA-125 level
- saline infusion sonohysterogram
- BUN and creatinine (renal function testing)
- LFTs
- chest x-ray
- CT scan of chest, abdomen, and pelvis
- MRI of uterus, pelvis, and abdomen
- PET scan of pelvis, abdomen, and chest
Treatment algorithm
Contributors
Authors VIEW ALL
Associate Professor
Division of Gynecologic Oncology
Department of Obstetrics, Gynecology, and Reproductive Sciences
Magee-Womens Hospital of UPMC
University of Pittsburgh School of Medicine
Pittsburgh
PA
Disclosures
ABO declares that he has no competing interests.
Clinical Director
Medical Gynecologic Oncology
Division of Hematology Oncology
Massachusetts General Hospital
Boston
MA
Disclosures
RTP declares that he is on the scientific advisory boards of: Genentech, Inc., AstraZeneca, Endocyte, Inc., Eisai Inc., Vascular Biogenics Ltd, Baxalta Oncology, AbbVie, and Clovis Oncology. RTP receives research funding from: Genentech, Inc., ImClone Systems, Inc., Endocyte, Inc., AstraZeneca., Eisai Inc., Amgen Inc., and Vascular Biogenics Ltd. RTP was an expert witness for Aventis Pharma S.A. Vs. Apotex Inc in 2009. RTP has received royalties from: BMJ, Blackwell Publishing Medicine at a glance, and UpToDate Advance Medical: Second Medical Opinion.
Assistant Professor
Department of Radiation Oncology
Brigham and Women’s Hospital/Dana-Farber Cancer Institute
Boston
MA
Disclosures
LJL declares that she has no competing interests.
Dr Alexander B. Olawaiye, Dr Richard T. Penson, and Dr Larissa J. Lee would like to gratefully acknowledge Dr Neil S. Horowitz and Dr Anthony H. Russell, previous contributors to this monograph. NSH and AHR declare that they have no competing interests.
Peer reviewers VIEW ALL
Associate Professor/Chief
Gynecologic Oncology
S/M Obstetrics & Gynecology (UCD)
University of Colorado Health Sciences Center
Aurora
CO
Disclosures
SAD declares that she has no competing interests.
Attending Radiologist
Assistant Professor of Radiology
Memorial Sloan-Kettering Cancer Center
New York
NY
Disclosures
SM declares that she has no competing interests.
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