Midwifery and Obstetrical Nursing

Sara Passos Silva

Viana do Castelo, Portugal

Title: Radiation- Associated Endometrial Cancer


Endometrial cancer developing after irradiation of pelvic area has been called radiation endometrial cancer (REC) and represents a group of heterogeneous tumors, a late and rare complication of radiotherapy. Side effects of radiation therapy come from damage to healthy cells and tissues near the treatment area predisposing to inflammation and damage to adjacent structures and rarely a second tumor can appear. Radiation endometrial cancers are rare but with a worse prognosis.
REC has been suggested to be a high risk disease with poorly differentiated tumors, high grade histological types of endometrial cancer with more local and distant spread and therefore with lower survival rates. The primary tumor is cervical cancer in the majority of written reports. The mean latency period between the diagnosis of first tumor and REC in written reports was 14 years, range from 5 to 28 years. 
A delay in the diagnosis of these tumors may explain why the disease presents in more advanced stages. Clinical presentation is often atypical with abdominal pain being the most common symptom whereas in sporadic types vaginal bleeding is almost always present.
The threshold for diagnostic work-up should be low in the presence of abdominal pain/ discomfort or a hematometra imaging finding in a woman with a prior history of pelvic irradiation after a long latency of exposure.