Malignant disease of the uterus

1. Big picture

Malignant disease of the uterus mainly means malignancy of the uterine corpus, especially:

1. Endometrial carcinoma — the most important and common uterine malignancy.
2. Uterine sarcomas — rare but aggressive tumours from myometrium or uterine connective tissue.
3. Carcinosarcoma — now generally managed biologically as a high-risk endometrial carcinoma, although historically grouped with sarcomas.

The classic exam presentation is:

Postmenopausal bleeding
→ endometrial cancer until proven otherwise
→ transvaginal ultrasound and/or endometrial sampling
→ histology confirms diagnosis
→ total hysterectomy + bilateral salpingo-oophorectomy ± nodal staging

The most important message: postmenopausal bleeding is never normal. Even one episode requires investigation.

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