The current study was conducted to see the frequency of epithelial malignancies of endometrium with focus on the common diagnostic pitfalls and identify morphological and immunohistochemical markers helpful in the differential diagnosis between different subtypes. It is a retrospective descriptive study carried out on 52 specimens of endometrial tumors received in Fatima Memorial Hospital, Lahore, Pakistan, during three years (2010–2012). Patients were divided into 5 age groups: <40, 41–50, 51–60, 61–70, and >70？yrs. Tissues were fixed in 10% formalin and processed and stained with haematoxylin-eosin. Stained slides were examined to determine the histological types by WHO classification, and immunohistochemistry for WT1, p53, ER/PR, and MIB1 was done in cases where morphology alone was not helpful in making a confirmed diagnosis. 80% of specimens were of endometrioid adenocarcinomas, 11% of serous tumors, 4% of clear cell carcinoma, and 4% of squamous cell carcinomas involving both cervix and endometrium. Most of the patients (28.84%) with endometrial carcinomas fall in the age range of 51–60？yrs. Endometrioid adenocarcinoma is the most common type of epithelial endometrial malignancies. Morphology is the keystone in the evaluation of these tumors, but immunohistochemistry can also be helpful in establishing the correct diagnosis. 1. Introduction Endometrial cancer is the most common gynecologic malignancy in western women with 41,000 new cases projected in the United States for 2006 [1], whereas rates in developing countries and Japan are four to five times lower. In India, the rates are as low as 4.3 per 100,000 [2]. Ninety-seven percent of all cancers of the uterus arise from the glands of the endometrium and are known as endometrial carcinomas [3]. Its annual incidence is estimated at 10–20 per 100,000 women and it is increasing [4, 5]. Approximately, 75% of cases are diagnosed at an early stage with a tumor confined to the uterine corpus [6]. It is the fourth most common cancer in women after carcinomas of breast, colorectum, and lung [7]. In the United States, endometrial carcinoma accounts for approximately 6000 deaths per year [4]. The median age of patients at the diagnosis of endometrial carcinoma is 63 years [8]. The incidence of endometrial carcinoma is highly dependent on age; there are 12 cases per 100,000 women at 40 years of age and 84 per 100,000 at 60 years [3]. Five percent of women with endometrial cancer are less than 40 years of age. Seventy-five percent of women with endometrial carcinoma are postmenopausal [9]. Historical
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