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Cancer
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Endometrial hyperplasia usually occurs before uterine cancer. Type I tumors are more common than Type II tumors, and are usually responsive to estrogen. They develop usually in young, obese, or perimenopausal women after endometrial hyperplasia. These tumors are usually low grade. The most common histology is endometrioid adenocarcinoma of grade 1 or 2. There may be microsatellite instability, and mutations of the genes. The Type II tumors are higher grade, including grade 3 endometrioid carcinomas and tumors that have nonendometrioid histology that may be clear cell, serous, carcinosarcoma, mixed cell, or undifferentiated. They are more common in older women, with 10%–30% having gene mutations.
Endocrinology and gonads
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
11.29. Primary spasmodic dysmenorrhoea is associated withmaternal history of the same disorder.anovulation.increased levels of prostaglandins in menstrual blood.irregular menstrual cycle.endometrial hyperplasia.
Preclinical and clinical development of new progesterone receptor antagonists with high receptor specificity for breast cancer treatment
Published in A. R. Genazzani, Hormone Replacement Therapy and Cancer, 2020
J. Hoffmann, H. Hess-Stumpp, R. B. Lichtner, U. Fuhrmann, G. Siemeister, M. R. Schneider
Unopposed estrogenic activity is known to increase the risk for endometrial hyperplasia. Therefore, the intrinsic estrogenic activity of ZK 230211 was analyzed in ovariectomized rats. No amplifications of uterine weight and luminal epithelial height, the classical estrogenic parameters, were observed when a high dose of 10 mg/animal per day was used (data not shown). These data indicate that ZK 230211 has no intrinsic estrogenic activity in vivo, which is consistent with results of in vitro studies.
Influence of phytoestrogens on endometrial thickness: a systematic review and meta-analysis
Published in Climacteric, 2022
M. J. Lindermann Peressoni Teixeira, C. Colonetti Colombo, L. Colonetti, M. Inês da Rosa, T. Colonetti
A thin endometrium is considered normal, whereas an endometrium with increased thickness may indicate cancer, hyperplasia or polyps [21]. The clinical significance of endometrial hyperplasia lies in the risk associated with the progression of this condition to endometrial cancer, and in the consideration of ‘atypical’ forms of hyperplasia as premalignant lesions [22]. Although the endometrium is thicker in women with endometrial cancer compared to those without the disease [23], in the RCT by Sammartino et al. [24], with 63 menopausal women using placebo or 36 mg/day genistein, there was no significant increase in endometrial thickness in the groups after 6 and 12 months of follow-up (3.1 mm vs. 3.0 mm at 6 months and 2.9 mm vs. 2.9 mm at 12 months in the intervention and control groups, respectively).
To treat or not to treat? An evidence-based practice guide for the management of endometrial polyps
Published in Climacteric, 2020
Two reviews looked specifically at the role of the levonorgestrel intrauterine system (LNG-IUS) for endometrial protection in high-risk women without endometrial polyps. Dominick et al. performed a Cochrane review on the efficacy of the LNG-IUS in protecting the endometrium in women undergoing tamoxifen treatment5. Wan and Holland performed a systematic review on the efficacy of the LNG-IUS compared to oral progestin in preventing endometrial pathology in women using estrogen replacement therapy22. Both reviews recognized a reduction in the incidence (prevention) of benign endometrial polyps and endometrial hyperplasia. Wan and Holland found that the LNG-IUS resulted in regression (treatment) of endometrial hyperplasia but not polyps. However, both studies concluded that there are insufficient data to recommend the LNG-IUS as either a first-line treatment or for prevention of endometrial polyps and hyperplasia.
Endometrial development during the transition to menopause: preliminary associations with follicular dynamics
Published in Climacteric, 2020
A. Baerwald, H. Vanden Brink, C. Lee, C. Hunter, K. Turner, D. Chizen
Endometrial hyperplasia is a condition of endometrial overgrowth that becomes most prevalent in the early postmenopause26. The diagnosis of endometrial hyperplasia is made clinically, following postmenopausal bleeding. Transvaginal ultrasonography is the initial test for evaluating postmenopausal bleeding. Endometrial thickness (ET) >5 mm in women with postmenopausal bleeding27,28 and >11 mm in those without postmenopausal bleeding29 has been correlated with an increased risk of endometrial cancer. Thus, measurements in these ranges warrant further investigation with endometrial biopsy. Endometrial hyperplasia is associated with obesity, and occurs in 6% of asymptomatic reproductive age women and 12% of asymptomatic postmenopausal women30. Endometrial cancer has been associated with endometrial hyperplasia in 3–4% of asymptomatic postmenopausal women31 and in 15% of perimenopausal women with polymenorrhagia/menorrhagia32. A cumulative 23–28% risk of progression to carcinoma has been reported for women with atypical hyperplasia33,34. The incidence of endometrial hyperplasia and carcinoma increases during the use of menopausal hormone therapy, more specifically with unopposed estrogen or sequential combined menopausal hormone therapy35,36.