Features of asymptomatic endometrial hyperplasia degeneration into endometrial adenocarcinoma
DOI:
https://doi.org/10.37800/RM.3.2023.57-62Keywords:
adenocarcinoma, endometrial hyperplasia, endometrial cancer, risk factors, asymptomatic course, PHC, patient-oriented approachAbstract
Relevance: Endometrial hyperplasia is a pathological condition of the uterus, characterized by abnormal proliferation of endometrial glands under the chronic unhindered action of estrogens. The clinical significance of endometrial hyperplasia lies in the associated risk of endometrial cancer progression. Uterine cancer is the fourth most common cancer in women.
The study aimed to show the need for an annual targeted medical examination of postmenopausal women with risk factors for endometrial cancer on the example of a clinical case.
Materials and Methods: A clinical case of the degeneration of asymptomatic endometrial hyperplasia into endometrial adenocarcinoma is described. The results of laboratory and instrumental studies and histological examination of postoperative endometrial scraping are also presented.
Results: Based on the analysis of complaints, anamnesis, examination, and clinical and laboratory data, patient N. was given a clinical diagnosis: Abnormal uterine bleeding (N93.9). Endometrial hyperplasia (N85.0). Postmenopausal period. Arterial hypertension of the 2nd degree (I 10). Obesity of the 2nd degree (E66). Anemia of moderate degree (D 64). Drug allergy (L 27.1).
Based on the diagnosis, an operation was performed: separate diagnostic curettage of the uterine cavity followed by a biopsy of endometrial scraping. Considering the morphological structure of the test sample, the histological conclusion was “endometrial adenocarcinoma.” Conclusion: The absence of symptoms of the disease for a long time and the irregularity of the patient’s visit to the local gynecologist prevented the timely diagnosis of precancerous disease at the PHC stage. It led to the emergency hospitalization of the patient. Therefore, postmenopausal women are recommended to undergo an annual mandatory medical examination, despite the absence of any disease symptoms, to avoid the transition of background diseases to oncological ones.
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