Clinical features

Abnormal uterine bleeding is the main symptom.

• Postmenopausal: any amount of vaginal bleeding, including spotting or staining

• Perimenopausal/premenopausal: metrorrhagia, menometrorrhagia

• Vaginal bleeding usually does not occur in type II cancer.

Later stages may present with pelvic pain, palpable abdominal mass, and/or weight loss.

Pelvic exam is often normal. Possible findings include:

• Abnormal cervix

• Enlarged uterus

• Evidence of local metastases

The majority of endometrial cancers are diagnosed at an early stage and have a good prognosis.

Localized metastasis: contiguous spread to the cervix and vagina, fallopian tubes, and ovaries (25% of cases)

Lymphogenic metastasis

• Seen in late stage cases

• Retroperitoneal spread, or involvement of the pelvic and/or para-aortic lymph nodes

Hematogenic metastasis

• Rare

• Occurs at a very late stage and usually in the lungs