Increased androgenic activity in well-differentiated endometrial adenocarcinoma

Abstract

Well-differentiated adenocarcinoma of the endometrium was diagnosed in 3 patients with polycystic ovary syndrome (PCO) and in 2 long-term users of an oral contraceptive (ethinylestradiol plus dimethisterone), all 5 at premenopausal age (from 28 to 36 years). These patients had high urinary testosterone. None underwent hysterectomy; the 3 with PCO were treated by wedge resection of the ovaries, and the 2 oral contraceptive users by simple curettage and discontinuation of oral contraception. The treatment was able to revert the endometrial pattern to normal as well as decrease the urinary level of testosterone. These patients were followed up for 3 to 10 years since the hormonal study and none has so far had a recurrence. The testosterone excretion level was determined in an additional 26 patients with well-differentiated adenocarcinoma and in 14 with undifferentiated adenocarcinoma of the endometrium. It was found that the testosterone excretion level was significantly increased in patients with well-differentiated adenocarcinoma but not in patients with undifferentiated adenocarcinoma of the endometrium.