Endometrial carcinoma in postmenopausal patients using hormone replacementtherapy: a report on four cases

Objective To report the occurrence of endometrial carcinoma In polyps in po stmenopausal patients using hormone replacement therapy (HRT). Setting A private hospital with facilities for carrying out hysteroscopy. Subjects Four postmenopausal patients who developed endometrial carcinoma w hile using HRT. Interventions Hysteroscopy with biopsy, immunohistochemical investigation f or oestradiol, progesterone receptors and p53 overexpression. Results All four cases of carcinoma were associated with endometrial polyps . The cancerous cells were positive for oestrogen receptors, negative for p rogesterone receptors and showed p53 overexpression in all cases. Conclusions The lack of detectable progesterone receptors in endometrial ca rcinomas arising in polyps in HRT patients indicates an unopposed action of oestrogens, which may accelerate the carcinomatous changes in polyps throu gh a p53 pathway.