Endometrial Carcinoma in a 25-Year-Old Woman Discovered on Routine Sterility Investigation

ENDOMETRIAL CARCINOMA IN A 25-YEAR-OLD WOMAN DISCOVERED ON ROUTINE STERILITY INVESTIGATION WARREN M. JACOBS, M.D., AND HAROLD

I.

DAILY, M.D.,

HousToN, TEXAS

(From the Department of Obstetrics and Gynecology, Baylor Unit•ersity College of Medicine, and the Infertility ClirJic of the Jefjerso11 Davis Hospital)

I

~

1951 Dock(•t1:y, T.ovrlady, and Foust rt>ported :36 c·asrs of adenocarcinoma of the cndonwtrium or•curring in women under 40 years of age. This group nornprisPcl 2.1 p<~r ernt of th<• total numlwr of carcinomas of the endometrium ( 1,694) sPen at the :Mayo Clinic· ovrr· a for·ty-yrar pt>riod. They emphasized that in this age group thPt'P was a high ineidrnee of hypertrnsion, obesity, clialwtPs, mHl ster·ility. It is lwcaus(' of this latter fac·tor that this case report is prrsented. Case Report

l\Jr~. H. H., a ;:!.5-year-olrl NPgro wom:ter with }10 per ctlnt motilit~· an•l }10 per cent normHl forms. A eomplete blood count wa~ :< no eYidence of tubal patenc~·.

An endometrial biops,\· taken on the first k aftvr the r·ompl<'tion of this nwnstrual po?riod, a hystf'rosalpingogram was done with t.he usu of fikiodan and aca1•ia. The report of this hystProsalpinp;ognnn was as follows: '' Tlw uterine ea.vity i~ normal in ~ize but is irregular in ~on tour and there are ~ome filling is a ;;mall amount of d:·e in the left tuhe." On the first day of the following men~trual perio•l a repeat hiopRy was taken allll the report obtaine cour~e was une,·entful and Rl1.-. wa;;
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436

JACOBS AND DAILY

Am.

J.

Obst. & Gyner. Augu>t, 1957

Fig. I.-Endometrial biopsy which shows adenocarcinoma.

Fig. 2.- Curettement.

This shows graduation from atypical endom etrium to frank adenocarcinoma.

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ENDOMETRIAL CANCER FOUND ON STERILITY EXAMINATION

437

The pathological report on the removed material was as follows: "Cervix uteri: eervicitis, chronic; endometrium, atrophy and fibrosis; uterus, no significant change; fallopian tubes, salpingitis, chronic; ovaries, fibrosis; appendix, no significant change. Comment: The previously described changes are probably a result of radiation therapy. No <>vidence of resitlual carcinoma seen either grossly or microseopically." This patient at the present time is being followed in the cancer clinic antl has no evidence of any reeurrent disease in the pelvis.

Summary A case of endometrial carcinoma in a patient 25 years of age was picked up on routine sterility investigation by endometrial biopsy. It is of interest to note that in a study of 36 cases of adenocarcinoma of the endometrium occurring in women under the age of 40 Dockerty, T1ovelady, and Foust stressed that infertility was a prominent clinical feature in these patients.

Reference Ilockerty, M. B., Lovelady, S. B., and Foust,

G.

T.:

AM.

J.

0BST. & GYNEC.

61: 96, 1951.