Answer:
Endometrial Carcinoma: The Likely Diagnosis
The most likely diagnosis based on the given information is endometrial carcinoma. The key findings are: a pelvic ultrasound on 1/17/2018 showing endometrial thickening , an endometrial biopsy on 2/13/2018 confirming endometrioid adenocarcinoma with clear cell and papillary serous features , and a hysterectomy on 2/26/2018 revealing endometrioid adenocarcinoma, grade 2, invading the inner third of the myometrium .
Endometrial carcinoma is the most common gynecologic malignancy in developed countries . Abnormal uterine bleeding is the most common presenting symptom, which prompted the initial ultrasound that detected the endometrial thickening . The biopsy confirmed the diagnosis of endometrial carcinoma with mixed histologic features, which is associated with more aggressive behavior . The hysterectomy specimen showed the tumor invaded the inner third of the myometrium, which is an important prognostic factor.
In summary, the combination of abnormal uterine bleeding, thickened endometrium on ultrasound, and biopsy-proven endometrial carcinoma with myometrial invasion on hysterectomy is consistent with endometrial carcinoma. Further management would depend on the stage and grade of the tumor.
Source:
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Thickened Endometrium: When to Intervene? A Clinical Conundrum.
No. 249-Asymptomatic Endometrial Thickening.
Endometrial thickness | Radiology Reference Article | Radiopaedia.org.
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