Endometrial cancer.

Endometrial cancer is the leading cause of gynecologic cancer in the United States. Etiologically, endometrial carcinoma usually results from unopposed estrogen stimulation of the endometrium, although non-estrogen-related forms occur as well. The most common presentation of endometrial cancer is postmenopausal bleeding. A variety of diagnostic modalities are available to aid in the detection of the disease, each with its own strengths and limitations. These modalities include endometrial biopsy, ultrasonography, saline infusion sonography, and hysteroscopy. A definitive diagnosis requires pathologic confirmation via endometrial biopsy or dilatation and curettage. Surgical staging of endometrial cancer will dictate how physicians manage the condition. For most women, staging and initial treatment are accomplished with total hysterectomy, bilateral salpingo-oophorectomy, and peritoneal washings. Surgery, radiation, and chemotherapy play a role in treatment, depending on tumor stage and grade. At present, there are no recommendations for screening the general population.