Case history
Case history
A 65-year-old woman with class III obesity (BMI 41) with hypertension and diabetes presents with post-menopausal vaginal bleeding, 12 years after the menopause. She has never been pregnant. She has a first-degree relative and a second-degree relative who have had endometrial cancer. Bleeding is scant but has persisted for more than 1 month. She has not recently used hormone replacement therapy and she had a normal Pap smear 6 months previously. Vaginal examination reveals evidence of recent bleeding.
Other presentations
Most women presenting with endometrial cancer are post-menopausal.[23] Less commonly, pre-menopausal women present with low-grade tumours, usually in the setting of nulliparity and obesity.[24][25]
Uncommonly, women with undiagnosed endometrial cancer are found to have atypical glandular cells of uncertain significance (AGUS) on routine Pap smear cytology.[26][27] Presentation with metastatic, hormonally responsive oligometastatic pulmonary disease, or bone metastases, may also occur but is uncommon.
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