Endometrial cancer combined with polycystic ovary syndrome in 9 women under 40‑years old: A case report

Jia,Xibiao; Yang,Lingyun; Xu,Pan; Li,Ningwei; Chen,Cen; Wang,Hongjing

doi:10.3892/br.2020.1357

Endometrial cancer combined with polycystic ovary syndrome in 9 women under 40‑years old: A case report

Authors:
- Xibiao Jia
- Lingyun Yang
- Pan Xu
- Ningwei Li
- Cen Chen
- Hongjing Wang
View Affiliations

Affiliations: Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
Published online on: September 9, 2020 https://doi.org/10.3892/br.2020.1357
Article Number: 50
Copyright: © Jia et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of the present study was to discuss the clinicopathological characteristics of endometrial carcinoma in young females with polycystic ovary syndrome (PCOS), and to review the current literature. A total of 9 patients with histopathologically confirmed endometrial cancer in young females with PCOS at the West China Second Hospital of Sichuan University between December 2007 and September 2013 were included. The clinicopathological characteristics of the patients were analyzed. The age range of the patients was 24‑38 years (median age, 29), all of the cases had abnormal vaginal bleeding and endometrioid adenocarcinoma was the most common histopathological subtype observed (8 cases, 88.9%). Of the patients, 2 had well‑differentiated cases and 7 patients had moderately differentiated cases. None of the patients received regular PCOS treatments and did not turn up for regular check‑ups before they were diagnosed with endometrial carcinoma. Additionally, 7 patients received staging laparotomy with a total abdominal hysterectomy and bilateral salpingo‑oophorectomy, 1 patient underwent an endometrial resection under hysteroscopy and the final patient received a high‑dose of medroxyprogesterone treatment without surgery. In conclusion, doctors should take into consideration that young women with PCOS may also exhibit an endometrial carcinoma, and diagnosing and treating the endometrial carcinoma as early as possible in the young patients with PCOS is necessary.

View Figures

View References

1	Goodarzi MO, Dumesic DA, Chazenbalk G and Azziz R: Polycystic ovary syndrome: Etiology, pathogenesis and diagnosis. Nat Rev Endocrinol. 7(219)2011.PubMed/NCBI View Article : Google Scholar
2	Sam S: Obesity and polycystic ovary syndrome. Obes Manag. 3:69–73. 2007.PubMed/NCBI
3	Morice P, Leary A, Creutzberg C, Abu-Rustum N and Darai E: Endometrial cancer. Lancet. 387:1094–1108. 2016.PubMed/NCBI View Article : Google Scholar
4	Bharatnur S, Kustagi P and Krishnamohan D: Endometrial carcinoma in a young woman: ‘30 is Not Immune’. J Obstet Gynaecol India. 61:686–688. 2011.PubMed/NCBI View Article : Google Scholar
5	Pellerin GP and Finan MA: Endometrial cancer in women 45 years of age or younger: A clinicopathological analysis. Am J Obstet Gynecol. 193:1640–1644. 2005.PubMed/NCBI View Article : Google Scholar
6	Zivanovic O, Carter J, Kauff ND and Barakat RR: A review of the challenges faced in the conservative treatment of young women with endometrial carcinoma and risk of ovarian cancer. Gynecol Oncol. 115:504–509. 2009.PubMed/NCBI View Article : Google Scholar
7	Ding DC, Chen W, Wang JH and Lin SZ: Association between polycystic ovarian syndrome and endometrial, ovarian, and breast cancer: A population-based cohort study in Taiwan. Medicine (Baltimore). 97(e12608)2018.PubMed/NCBI View Article : Google Scholar
8	Park JC, Lim SY, Jang TK, Bae JG, Kim JI and Rhee JH: Endometrial histology and predictable clinical factors for endometrial disease in women with polycystic ovary syndrome. Clin Exp Reprod Med. 38:42–46. 2011.PubMed/NCBI View Article : Google Scholar
9	Navaratnarajah R, Pillay OC and Hardiman P: Polycystic ovary syndrome and endometrial cancer. Semin Reprod Med. 26:62–71. 2008.PubMed/NCBI View Article : Google Scholar
10	Laughlin-Tommaso SK, Hesley GK, Hopkins MR, Brandt KR, Zhu Y and Stewart EA: Clinical limitations of the international federation of gynecology and obstetrics (FIGO) classification of uterine fibroids. Int J Gynaecol Obstet. 139:143–148. 2017.PubMed/NCBI View Article : Google Scholar
11	Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group: Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81: 19-25, 2004.
12	Evans-Metcalf ER, Brooks SE, Reale FR and Baker SP: Profile of women 45 years of age and younger with endometrial cancer. Obstet Gynecol. 91:349–354. 1998.PubMed/NCBI View Article : Google Scholar
13	Gitsch G, Hanzal E, Jensen D and Hacker NF: Endometrial cancer in premenopausal women 45 years and younger. Obstet Gynecol. 85:504–508. 1995.PubMed/NCBI View Article : Google Scholar
14	Tran BN, Connell PP, Waggoner S, Rotmensch J and Mundt AJ: Characteristics and outcome of endometrial carcinoma patients age 45 years and younger. Am J Clin Oncol. 23:476–480. 2000.PubMed/NCBI View Article : Google Scholar
15	Hanprasertpong J, Sakolprakraikij S and Geater A: Endometrial cancer in Thai women aged 45 years or younger. Asian Pac J Cancer Prev. 9:58–62. 2008.PubMed/NCBI
16	Shah MM and Wright JD: Management of endometrial cancer in young women. Clin Obstet Gynecol. 54:219–225. 2011.PubMed/NCBI View Article : Google Scholar
17	Cheung AP: Ultrasound and menstrual history in predicting endometrial hyperplasia in polycystic ovary syndrome. Obstet Gynecol. 98:325–331. 2001.PubMed/NCBI View Article : Google Scholar
18	Speert H: Carcinoma of the endometrium in young women. Surg Gynecol Obstet. 88:332–336. 1949.PubMed/NCBI
19	Gottschau M, Kjaer SK, Jensen A, Munk C and Mellemkjaer L: Risk of cancer among women with polycystic ovary syndrome: A Danish cohort study. Gynecol Oncol. 136:99–103. 2015.PubMed/NCBI View Article : Google Scholar
20	Escobedo LG, Lee NC, Peterson HB and Wingo PA: Infertility-associated endometrial cancer risk may be limited to specific subgroups of infertile women. Obstet Gynecol. 77:124–128. 1991.PubMed/NCBI
21	Iatrakis G, Zervoudis S, Saviolakis A, Troulos M, Antoniou E, Sarantaki A, Lykeridou K and Kourounis G: Women younger than 50 years with endometrial cancer. Eur J Gynaecol Oncol. 27:399–400. 2006.PubMed/NCBI
22	Apparao KB, Lovely LP, Gui Y, Lininger RA and Lessey BA: Elevated endometrial androgen receptor expression in women with polycystic ovarian syndrome. Biol Reprod. 66:297–304. 2002.PubMed/NCBI View Article : Google Scholar
23	Dang CV and Semenza GL: Oncogenic alterations of metabolism. Trends Biochem Sci. 24:68–72. 1999.PubMed/NCBI View Article : Google Scholar
24	Furberg AS and Thune I: Metabolic abnormalities (hypertension, hyperglycemia and overweight), lifestyle (high energy intake and physical inactivity) and endometrial cancer risk in a Norwegian cohort. Int J Cancer. 104:669–676. 2003.PubMed/NCBI View Article : Google Scholar
25	Pillay OC, Te Fong LF, Crow JC, Benjamin E, Mould T, Atiomo W, Menon PA, Leonard AJ and Hardiman P: The association between polycystic ovaries and endometrial cancer. Hum Reprod. 21:924–929. 2006.
26	MacLaughlan SD, Palomino WA, Mo B, Lewis TD, Lininger RA and Lessey BA: Endometrial expression of Cyr61: A marker of estrogenic activity in normal and abnormal endometrium. Obstet Gynecol. 110:146–154. 2007.PubMed/NCBI View Article : Google Scholar
27	Dahlgren E, Friberg LG, Johansson S, Lindström B, Odén A, Samsioe G and Janson PO: Endometrial carcinoma; ovarian dysfunction-a risk factor in young women. Eur J Obstet Gynecol Reprod Biol. 41:143–150. 1991.PubMed/NCBI View Article : Google Scholar
28	Thiel FC and Halmen S: Low-grade endometrial stromal sarcoma-a review. Oncol Res Treat. 41:687–692. 2018.PubMed/NCBI View Article : Google Scholar