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Precursors of Endometrial Carcinoma

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Blaustein's Pathology of the Female Genital Tract

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Abstract

Endometrial hyperplasia often precedes the development of endometrioid carcinoma, the most common type of endometrial carcinoma. Obesity, anovulatory cycles, and exogenous hormones are associated with both endometrioid carcinoma and hyperplasia. In addition, the risk of endometrial hyperplasia is associated with increasing body mass index and nulliparity (Epplein et al. 2008; Wise et al. 2016; Guraslan et al. 2016). All of these factors are thought to result in unopposed estrogen stimulation of the endometrium. The role of unopposed estrogen stimulation in the development of endometrial hyperplasia and carcinoma is further supported by studies demonstrating elevated serum estrogen levels in patients with endometrioid carcinoma (Brinton et al. 1992; Potischman et al. 1996). Atypical hyperplasia/endometrioid intraepithelial neoplasia is considered the direct precursor to endometrioid carcinoma. However, other histologic types of endometrial carcinoma are less commonly associated with estrogenic stimulation (Sherman et al. 1997). Serous carcinoma is the prototypic endometrial carcinoma that is typically not related to estrogenic stimulation or hyperplasia. It usually arises in atrophic endometrium through a precursor lesion called serous endometrial intraepithelial carcinoma (SEIC). The following discussion summarizes current knowledge about these precursor lesions including their differential diagnosis, treatment, and relationship to endometrial carcinoma.

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Author information

Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, Division of Gynecologic Pathology, Weill Cornell Medical College and New York Presbyterian Hospital, New York, NY, USA

    Lora Hedrick Ellenson

  2. Department of Pathology, Division of Gynecologic Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Brigitte M. Ronnett

  3. Departments of Gynecology, Obstetrics, Pathology and Oncology, Division of Gynecologic Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Robert J. Kurman

Authors
  1. Lora Hedrick Ellenson
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  2. Brigitte M. Ronnett
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  3. Robert J. Kurman
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Correspondence to Lora Hedrick Ellenson .

Editor information

Editors and Affiliations

  1. Johns Hopkins University Dept. Gynecology, Obstetrics & Pathology, Baltimore, MD, USA

    Robert J. Kurman

  2. Dept. Urology, New York Presbyterian Hospital Weill Cornell Medical Center, New York, NY, USA

    Lora Hedrick Ellenson

  3. Johns Hopkins University Dept. Gynecology, Obstetrics & Pathology, Baltimore, MD, USA

    Brigitte M. Ronnett

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Ellenson, L.H., Ronnett, B.M., Kurman, R.J. (2018). Precursors of Endometrial Carcinoma. In: Kurman, R., Hedrick Ellenson, L., Ronnett, B. (eds) Blaustein's Pathology of the Female Genital Tract. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3165-7_8-2

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  • DOI: https://doi.org/10.1007/978-1-4614-3165-7_8-2

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