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Endometrial cancers are most commonly endometrioid adenocarcinomas, but may also be adenosquamous, serous papillary or clear cell adenocarcinomas. Staging follows the FIGO (International Federation of Gynaecologists and Obstetricians) staging system. Endometriosis is a typically benign condition, and rarely progresses to malignancy. However, there is some evidence to suggest an increased risk of ovarian cancer in patients with longstanding endometriosis. The pathological diagnosis of endometrial carcinoma can be difficult. Endometrial hyperplasia and well-differentiated adenocarcinoma histologically have a close resemblance, and differentiation between the two may not be straight forward. In addition, classification systems are complex, and intra- and inter- observer reproducibility in histological diagnosis (between hyperplasia and low grade carcinoma) is low. In the rare cases where endometrioid carcinoma is found in the urinary tract, it can also be difficult on morphological grounds alone to distinguish it from poorly differentiated urothelial carcinoma or other types of gynaecological tract malignancy, and immunohistochemistry may be required to make the distinction. This case is particularly interesting in several respects. Endometriosis is rarely found in the bladder, and when it is, will usually be on the outer bladder wall rather than within, as in this case. Malignant progression of endometriosis is uncommon and not well understood, in particular progression to endometrial cancer, making this case again extremely unusual.
Citation: Sarfraz A, Aitken L, Wilson J, Byrne D (2014) Endometrioid Endometrial Carcinoma of the Urinary Bladder - A Diagnostic Challenge. Medical Diagnostics 4:155. doi: 10.4172/2168-9784.1000155