343 ENDOMETRIAL CARCINOMA AND HYPERPLASIA IN PATIENTS WITH GONADAL DYSGENESIS RECEIVING ESTROGEN-PROGESTERONE THERAPY

Abstract

Fifty-one patients with gonadal dysgenesis receiving estrogen-progesterone replacement therapy for periods of six months to twenty years were studied. Endometrial biopsies or dilatation and curettage were obtained in forty-seven patients. One patient on diethylstilbesterol had atypical endometrial hyperplasia which progressed to adenoepidermoid carcinoma. Six patients had benign cystic hyperplasia. Endometrial abnormalities occurred in patients with a duration of estrogen therapy greater than 3-5/12 years and who received a total lifetime estrogen dose exceeding 2500 mg of conjugated estrogen or its equivalent. Five patients who developed endometrial hyperplasia had taken cyclic estrogen-progesterone therapy; the sixth took unopposed estrogen therapy. Total nuclear estradiol binding was measured in six patients with Turner Syndrome and nine control women. Two of the Turner patients had endometrial hyperplasia. Nuclear binding in these two subjects did not differ from that of the other patients with Turner Syndrome. Nuclear binding in the Turner patients (range 3-101/DPM ng DNA) was not different from that of nine control women at comparable stages of the menstrual cycle (34-429 DPM/ng DNA). Cytoplasmic binding of estradiol was not different in two patients with Turner Syndrome with hyperplasia from the four without.