endometrioidtype

Endometrioid type refers to a histologic subtype of carcinoma that most commonly occurs in the endometrium and, less frequently, in the ovaries. It is distinguished by glandular structures that resemble normal endometrial tissue, but with malignant features such as nuclear atypia, increased mitotic activity, and stromal invasion. The lesion is typically classified into low‑grade and high‑grade categories based on mitotic index and the extent of cytologic atypia. Low‑grade endometrioid carcinomas tend to behave less aggressively, whereas high‑grade tumors are associated with a higher probability of extrauterine spread.

Incidence and Risk Factors

The endometrioid type is the second most common endometrial carcinoma after the papillary serous subtype. Risk factors mirror those for endometrial cancer in general and include obesity, chronic estrogen exposure without adequate progesterone counterbalance, tamoxifen use, and genetic predispositions such as Lynch syndrome. In the ovarian setting, endometrioid carcinomas represent roughly 10–20 % of epithelial ovarian cancers and frequently co‑occur with endometriosis.

Diagnostic Workup

Diagnosis is confirmed by histopathologic examination of biopsy or surgical specimens. Immunohistochemical stains (for estrogen/progesterone receptors, p53, and mismatch repair proteins) aid in subtyping and assessment of genetic syndromes. Imaging studies such as transvaginal ultrasound, MRI, and CT are employed to evaluate disease extent and staging.

Treatment

Management strategies are disease‑specific. For uterine endometrioid carcinoma, early‑stage low‑grade tumors are usually treated with hysterectomy and bilateral salpingo‑oophorectomy, often sparing the ovaries in young women. Adjuvant radiation or hormonal therapy may be considered. High‑grade or advanced disease typically warrants comprehensive surgical staging followed by adjuvant chemotherapy, often carboplatin plus paclitaxel, and sometimes radiation. Ovarian endometrioid carcinomas are managed similarly to other epithelial ovarian cancers, with cytoreductive surgery followed by platinum‑based chemotherapy.

Prognosis

Overall survival depends strongly on stage at diagnosis. Low‑grade endometrioid carcinoma confined to the uterus generally carries a favorable prognosis with five‑year survival rates exceeding 90 %. Advanced or high‑grade disease reduces the five‑year survival to between 30 % and 60 %, reflecting the need for aggressive multimodal therapy.

Endometrioid type cancers are a clinically significant subset of gynecologic malignancies, and careful histopathologic classification guides treatment planning and prognostication.