Endometrial carcinoma in postmenopausal patients using hormone replacement therapy: a report on four cases

Objective To report the occurrence of endometrial carcinoma In polyps in postmenopausal patients using hormone replacement therapy (HRT). Setting A private hospital with facilities for carrying out hysteroscopy. Subjects Four postmenopausal patients who developed endometrial carcinoma while using HRT. Interventions Hysteroscopy with biopsy, immunohistochemical investigation for oestradiol, progesterone receptors and p53 overexpression. Results All four cases of carcinoma were associated with endometrial polyps. The cancerous cells were positive for oestrogen receptors, negative for progesterone receptors and showed p53 overexpression in all cases. Conclusions The lack of detectable progesterone receptors in endometrial carcinomas arising in polyps in HRT patients indicates an unopposed action of oestrogens, which may accelerate the carcinomatous changes in polyps through a p53 pathway.