HIGH-GRADE ENDOMETRIAL CARCINOMA IN SECRETORY ENDOMETRIUM IN YOUNG-WOMEN - A REPORT OF 5 CASES

Five cases of high-grade carcinoma occurring adjacent to secretory end ometrium are described. One of the patients had the Lynch II syndrome, the others appeared to be sporadic. None of these cases appeared to b e related to hyperestrogen. The presenting symptom in four was abnorma l vaginal bleeding, and the other case was found incidentally in the c ourse of investigations for infertility. There were delays in diagnosi s due to the patients not seeking medical attention for abnormal bleed ing, a reluctance of clinicians to perform dilatation and curettage, a nd difficulty in pathologic interpretation of the curettings. The inte rpretive problems related to extremely small volumes of tumor, difficu lty in distinguishing carcinoma from menstrual endometrium, and diffic ulty in determining whether a carcinoma was endometrial rather or endo cervical in origin. The tumors were aggressive, manifest by their high grade and stage. The importance of these cases is to impress upon cli nicians and pathologists that endometrial carcinoma may occur in young women without any of the usual risk factors. (C) 1996 Academic Press, Inc.