Type I endometrial cancer: endometrioid adenocarcinomas derived from atypical endometrial hyperplasiaType II endometrial cancer: tumors of non­endometrioid histology

1. Type 1 endometrial carcinoma: Tumors look like normal endometrial glands.- Mutations in PTEN → ↑ signaling in the PI3K/AKT pathway → ↑ estrogen- Risk factors: Obesity, tamoxifen, postmenopausal estrogen thearpy without progestin, nulliparity, early menarche, late menopause, chronic anovulation, Lynch syndrome2. Type 2 endometrial carcinoma: Several subtypes, most commonly serous carcinoma- Not linked to estrogen- Affect women who have endometrial atrophy and lower body weight, ↑ women of African descent- More aggressive

Clinical features:- Abnormal vaginal bleeding- Enlargement of the uterus (abdominal discomofort, cramping)

Diagnosis:- Transvaginal ultrasound to determine if endometrium is abnormally thick (>4 mm) → Biopsy/Dilation and curretage to confirm diagnosis

Therapy: - Surgery: Hysterectomy and bilateral salpingo-oophorectomy and removal of lymph nodes ± radiation/chemotherapy

Complications: Pyometra (purulent infection of the endometrium)