Endometrial intraepithelial neoplasia

A precancerous condition of the endometrium

Endometrial intraepithelial neoplasia (EIN) is a precancerous condition of the endometrium, the lining of the uterus. It is characterized by the presence of abnormal glandular cells that have the potential to progress to endometrial cancer.

Pathophysiology

EIN is considered a precursor to endometrial carcinoma, particularly endometrioid adenocarcinoma. The condition arises due to genetic mutations and hormonal imbalances, particularly involving estrogen and progesterone. These hormonal changes lead to the proliferation of endometrial cells, which can become atypical and form neoplastic lesions.

Diagnosis

The diagnosis of EIN is typically made through a combination of endometrial biopsy and histopathological examination. The criteria for diagnosing EIN include:

• Glandular crowding: The glands are closely packed, with a gland-to-stroma ratio greater than 1:1.
• Cytological atypia: The cells lining the glands show nuclear atypia, such as increased nuclear size and irregular nuclear contours.
• Exclusion of carcinoma: There is no evidence of invasive cancer.

Clinical Presentation

Patients with EIN may present with abnormal uterine bleeding, particularly in postmenopausal women. Other symptoms can include pelvic pain and menorrhagia.

Management

The management of EIN involves addressing the underlying hormonal imbalance and removing the abnormal tissue. Treatment options include:

• Progestin therapy: This hormonal treatment can help reverse the atypical changes in the endometrium.
• Hysterectomy: Surgical removal of the uterus is often recommended for women who have completed childbearing or have a high risk of progression to cancer.

Prognosis

With appropriate treatment, the prognosis for patients with EIN is generally good. However, without treatment, there is a significant risk of progression to endometrial cancer.

Prevention

Preventive measures for EIN include maintaining a healthy weight, managing polycystic ovary syndrome (PCOS), and using hormonal contraceptives to regulate menstrual cycles and reduce the risk of endometrial hyperplasia.

Related pages

• Endometrial cancer
• Endometrial hyperplasia
• Uterine fibroids
• Polycystic ovary syndrome

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  Histopathology of endometrial intraepithelial neoplasia (EIN)
• EIN PTEN
  EIN PTEN