The association of endometrial carcinoma (EC) with endocrinopathies manifested by obesity, nulliparity, and/or increased estrogen levels of exogenous or endogenous estrogens is now well-known. EC is also seen in patients without these findings. Are these different cancers? Seventy-four cases of EC were reviewed and classified into two groups: group I, with associated adenomatous hyperplasia (AH), 31 cases; and group 11, without associated AH, 43 cases. Group I included more well-differentiated and less invasive carcinomas; histologically, the pattern was glandular in all cases. In Group 11, the EC were less well-differentiated, more invasive, and included, besides adenocarcinomas, clear-cell, papillary, and anaplastic carcinomas with giant tumor cells. Squamoid features were found in both groups. The possible existence of two types of EC, a hormonaldependent EC associated with AH (which is believed to result from hyperestrogenism, and to have a better clinical prognosis), and an "independent" EC, not associated with AH, is discussed.
Cancer 56: 1452-1455. 1985.
HE STEADILY RISING NUMBER Of endometrial car-
T cinomas (EC) in the female population of the United States and of most of the Western World is assumed to be generally related to the increase in life expectancy because EC is a malignancy affecting mostly elderly patients. Associated circumstances are dietary factors leading to obesity, nulliparity or oligoparity, and exogenous estrogen therapy for postmenopausal symptoms, all of which are more prevalent in affluent, white patient^.^-^ Endometrial carcinoma, however, is found also in nonaffluent, nonwhite6 female populations, and in multiparous, thin patients, as well as in patients who have never received hormone therapy. The outcome of the cancer in these cases seems to be less favorable.6
This study analyzes EC histologically and attempts to determine whether those with associated adenomatous hyperplasia (AH) have different characteristics.
Adenomatous hyperplasia (AH) is a pathologic condition of the endometrium known for reflecting hyper-