Endometrial cancer classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]

Overview

Endometrial cancer may be classified according to histology into either type I comprising 80% of endometrial cancers or type II accounting for around 20%.

Classification

Endometrial cancer may be classified according to histology into 2 types:

• Type I
• Type II

Type	Histology	Prognosis	Pathogenesis	Prevalence
Type I	Endometroid (adenocarcinoma)	Favorable (estrogen-responsive)	• May arise from atypical hyperplasia • Linked to unopposed estrogen stimulation	80%
Type II	• Endometroid • Serous • Clear cell • Mucinous • Squamous • Mesonephric • Undifferentiated	Typically bad prognosis	• Develops from atrophic endometrium • Not linked to hormonally driven pathogenesis	15-20%

Classification Based on Pathogenesis

• Endometrial cancers are classified into either type 1 or type 2:

• Type 1 may arise from complex atypical hyperplasia and is pathogenetically linked to unopposed estrogenic stimulation.
• Type 2 develops from atrophic endometrium and is not linked to hormonally driven pathogenesis.

Classification Based on Histopathological Subtype

There are 7 subtypes of endometrial cancer based on histopathology:

1. Endometrioid (75%–80%)(The most common endometrial cancer cell type is endometrioid adenocarcinoma, which is composed of malignant glandular epithelial elements)

• Ciliated adenocarcinoma
• Secretory adenocarcinoma
• Papillary or villoglandular
• Adenocarcinoma with squamous differentiation

• Adenoacanthoma
• Adenosquamous (Adenosquamous tumors contain malignant elements of both glandular and squamous epithelium)

2. Uterine papillary serous (<10%)

3. Mucinous (1%)

4. Clear cell (4%)

5. Squamous cell (<1%)

6. Mixed (10%)

7. Undifferentiated

References

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