Endometrial Carcinoma in Women Aged 40 Years and Younger

Abstract

Context.-Endometrial carcinoma is a disease of older postmenopausal women, and is relatively uncommon in patients younger than 40 years. Endometrial carcinomas in this age group may be familial, associated with Lynch syndrome, or sporadic.Objectives.-To present our current knowledge of endometrial carcinomas in women younger than 40 years.Data Sources.-The review is based on previously published articles on this topic.Conclusions.-Most endometrial carcinomas that occur in this age group are associated with estrogen excess. They are usually low-grade endometrioid carcinomas that present at low stages and are associated with favorable clinical outcomes. Tumors associated with mismatch repair abnormalities and Lynch syndrome appear to be distinct, with worse prognostic factors and, possibly, clinical behavior. Conservative hormonal therapy and ovarian conservation are reasonable considerations in the management of these young patients, but carry the risk of tumor progression, recurrence, and an occult synchronous or metachronous ovarian carcinoma.

The Significance of Mismatch Repair Deficiency in Young Patients With Endometrial Cancer

“…These findings were discussed in a recent review article by Garg and Soslow (22). However, there were only few studies that examined the significance of the loss of individual MMR proteins.…”

ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: Diagnosis, Treatment and Follow-up

“…Tumours associated with mismatch repair abnormalities and LS appear to be distinct, with worse prognostic factors and worse clinical outcome. 11 According to a recent meta-analysis involving six studies and 3,132 cancer cases, relative risk (RR) for developing endometrial cancer in women with metabolic syndrome is 1.89 (95% confidence interval [CI] 1.34Y2.67, P = G0.001). According to individual components of metabolic syndrome, obesity is associated with the greatest increase in RR of 2.21 (P = G0.001).…”

Direct effects of metformin in the endometrium: a hypothetical mechanism for the treatment of women with PCOS and endometrial carcinoma

“…The two main types of EC are estrogen-dependent type I and estrogen-independent type II carcinomas [6]. Type I EC is the most prevalent type – accounting for 75%–85% of all ECs – and occurs primarily in postmenopausal women [7]. However, approximately 25% of women with EC are pre-menopausal and 5% of cases are diagnosed at younger than 40 years of age [2].…”