HISTOPOTHOLOGICAL STUDY OF ENDOMETRIALCARCINOMA IN WOMEN WITH POSTMENOPAUSAL BLEEDING

Postmenopausal bleeding represents one of the most common reasons for referral to gynecological services, largely due to suspicion of an underlying endometrial malignancy. The objective of this study is to find the prevalence of endometrial carcinoma in women with post-menopausal bleeding and to study the histopathology of endometrial carcinoma. Materials And Methods:A three and half years retrospective (May 2010 to Oct 2013) and one and half year prospective study (Nov 2013 to April 2015) of all D&C and hysterectomy specimens of patients presenting with postmenopausal bleeding were undertaken in the department of Pathology, KIMS Hubballi. Results:In our study out of 122 cases of postmenopausal bleeding there were 22 cases of endometrial carcinoma. In 22 cases 21 were endometrial adenocarcinoma 1 case was carcinosarcoma. Majority were in 56 to 65 years. There were various histopathological patterns showing endometriatype, endometroid type with papillary differentiation, squamousdifferentiation, mucinous differentiation and 1 case showingcarcinosarcoma. Majority ,18 cases (85.7%) were in Grade I, 2 cases (9.5%) were in Grade II and 1 case was in Grade III. Out of 22 cases 15 cases were hysterectomy specimen,7 cases were curettage samples. In 15 cases ,2 cases were confined to uterus (Stage IA),9 cases (60.6%) were stage IB,1 cases were stage IC.There was 1 case in in stage IIA with involvement of endocervicalmucosa, there were 2 cases in stage III with each showing involvement of bilateral ovaries(Stage IIIA) and bilateral pelvic lymph nodes (Stage IIIC).In our study there were 1cases of carcinosarcoma in stage IB in the age group 55 years. Hence postmenopausal bleeding is a dreaded and alarming symptoms and requires complete evaluation in order to ensure the absence of malignancy and to identify and treat high risk patients.