The Indian Practitioner

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Accidental Early Diagnosis of Endometrial Adenocarcinoma by Pap Smear during a Cervical Cancer Prevention Study: A Case Report


Affiliations
1 Vile Parle, Mumbai and Ayurvidya Prasarak Mandal - Ayurved Mahavidyalaya, Sion, Mumbai, India
2 The Lab, Khar, Mumbai, India
3 Ayurvidya Prasarak Mandal-Ayurved Mahavidyalaya, Sion, Mumbai, India
4 Department of Obstetrics & Gynecology, Ayurvidya Prasarak Mandal-Ayurved Mahavidyalaya, Sion, Mumbai, India
5 Kasturba Health Society-Medical Research Centre, Vile Parle, Mumbai, India
     

   Subscribe/Renew Journal


Endometrial carcinoma is less common than cervical cancer but the disadvantage is that there is no mass screen-ing method that can be used for early detection or prevention. The Papanicolaou (Pap) smear is useful for screening and preventing cervical cancer but occasionally also detects endometrial cancer, usually in advanced stages. Here we describe a case of endometrial cancer which was not detected in the initial Pap smear of a 40 year old woman. She had Low-Grade Intraepithelial Squamous Lesion (LSIL) with normal endocervical cells in the initial smear. Since she participated in a cervical cancer prevention study with antimicrobials and turmeric extract, her Pap smear was repeated within 5 weeks. Endometrial adenocarcinoma was clearly suspected in this follow-up Pap smear and the case was subsequently investigated and confirmed as Endometrial carcinoma. This case is presented for its rarity of clinical features: younger age, absence of common risk factors, and early detection because of cervical cancer prevention programs. A review of the literature reveals the potential of curcumin and turmeric extracts in controlling gynaecological cancers.

Keywords

Pap Smears, Endometrial Carcinoma, Cervical Cancer Prevention, Cancer Screening, Risk Factors For Can-cer, Early Diagnosis Of Endometrial Adenocarcinoma.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Khazaei Z, Dehkordi AH, Amiri M et al.The incidence and mortality of endometrial cancer and its association with body mass index and human development index in Asian population. WCRJ 2018; 5: e1174:1-11.

  • American Cancer Society: Cancer Prevention & Early Detection. Facts & Figures 2019-2020.

  • Nayar R, Wilbur DC. The Pap Test and Bethesda 2014. Acta Cytologica 2015;59: 121–132.

  • Gerbera B, Krausea H, Mullera H et al. Ultrasonographic detection of asymptomatic endometrial cancer in postmenopausal patients offers no prognostic advantage over symptomatic disease discovered by uterine bleeding. Europ J Cancer, 2001; 37: 64-71.

  • Joshi JV, Saraiya UB. The cytological diagnosis of adenocarcinoma of the female genital tract. Ind J Cancer 1975;12: 274-278.

  • Asma N, Hephzibah R, Parinitha SS, Rao R, Shastri D. Pap Smear in Endometrial Adenocarcinoma: Does It Have a Role? Asian Pac J Cancer Prev, 2017;18 : 1145-1150.

  • Joshi JV, Jagtap SS, Rastogi N et al. Integrated treatment with antimicrobials and oral turmeric extract Haldone® for women with cervical Low Grade Squamous Intraepithelial Lesions. Innovative Technologies, Late Breaking Abstracts; Abstract ID 000638- ASCCP2019 4-6 April, 2019, Atlanta, USA, Pg 11.

  • Shivprasad C. Sheehan’s syndrome: Newer advances. Indian J Endocrinol Metab. 2011; 15(Suppl3): S203–S207.

  • Joshi JV, Rastogi N, Jagtap SS et al.Accidental Early Diagnosis of Adenocarcinoma of Endometrium During Close Monitoring in Haldone® Study (Case Report).

  • Poster presentation, International Conference on Women’s Reproductive Health, Golden Jubilee Conference by NIRRH, ICMR, 20-23rdFebruary, 2020.

  • Beral V, Bull D, Reeves G. Million Women Study Collaborators. Endometrial cancer and hormone-replacement therapy in the Million Women Study. Lancet. 2005;365: 1543-51.

  • Joshi JV, Paradkar PH , Jagtap SS, et al. Chemopreventive Potential & Safety Profile of NBFR-03 (Supercritical Curcuma longa exract) in Women with Cervical Low- Grade Squammous Intraepithelial Neoplasia in Papanicolaou Smears. Asian Pacific J Cancer Prev, 2011;12:3305-11.

  • Joshi JV, Paradkar PH, Jagtap S et al(2016). Persistent chemopreventive action of integrative treatment of Low-Grade Cervical Intraepithelial Neoplasia- Case series. Journal of Ayurveda and Integrative Medicine7:109-12.

  • Shanmugam M, Rane G, Mathi Kanchi MM et al. The multifaceted role of curcumin in cancer prevention and treatment. Molecules 2015; 20: 2728-69.

  • Paradkar P, Dandekar S, Joshi JV, Amonkar AJ, Vaidya AB. Synergistic Anticancer Activity of the Medicinal Plant Bioactives: Curcuma Longa Linn And Tinospora Cordifolia Willd. in Cervical Cancer.Int J Pharm Sci Rev Res. 2017; 42:151-60.

  • Chen Q, Gao Q, Chen Ket al. Curcumin suppresses migration and invasion of human endometrial carcinoma cells. Oncol Lett. 2015 ; 10: 1297–1302.

  • Saydmohammed M, Joseph D, Syed V. Curcumin suppress-es constitutive activation of STAT-3 by up-regulating protein inhibitor of activated STAT-3 (PIAS-3) in ovarian and endometrial cancer cells.J Cell Biochem. 2010;110:447-56.

  • Sirohi VK, Popli P, Sankhwar P et al. Curcumin exhibits anti-tumor effect and attenuates cellular migration via Slit-2 mediated down-regulation of SDF-1 and CXCR4 in endometrial adenocarcinoma cells. J Nutr Biochem. 2017;44:60-70.

  • Khoury DE, Matar R, Touma T. Curcumin and endometrial carcinoma: an old spice as a novel agent. Int J Women’s Health. 2019; 11: 249–256.

  • Tuyaerts S, Rombauts K, Everaert T et al. A Phase 2 Study to Assess the Immunomodulatory Capacity of a Lecithin-based Delivery System of Curcumin in Endometrial Cancer. Front. Nutr. 2018;5:1-14.


Abstract Views: 236

PDF Views: 0




  • Accidental Early Diagnosis of Endometrial Adenocarcinoma by Pap Smear during a Cervical Cancer Prevention Study: A Case Report

Abstract Views: 236  |  PDF Views: 0

Authors

Jayashree Joshi
Vile Parle, Mumbai and Ayurvidya Prasarak Mandal - Ayurved Mahavidyalaya, Sion, Mumbai, India
Sham Ratnaparkhi
The Lab, Khar, Mumbai, India
Priya Walwatker
Ayurvidya Prasarak Mandal-Ayurved Mahavidyalaya, Sion, Mumbai, India
Sujata Jagtap
Department of Obstetrics & Gynecology, Ayurvidya Prasarak Mandal-Ayurved Mahavidyalaya, Sion, Mumbai, India
Neerja Rastogi
Kasturba Health Society-Medical Research Centre, Vile Parle, Mumbai, India

Abstract


Endometrial carcinoma is less common than cervical cancer but the disadvantage is that there is no mass screen-ing method that can be used for early detection or prevention. The Papanicolaou (Pap) smear is useful for screening and preventing cervical cancer but occasionally also detects endometrial cancer, usually in advanced stages. Here we describe a case of endometrial cancer which was not detected in the initial Pap smear of a 40 year old woman. She had Low-Grade Intraepithelial Squamous Lesion (LSIL) with normal endocervical cells in the initial smear. Since she participated in a cervical cancer prevention study with antimicrobials and turmeric extract, her Pap smear was repeated within 5 weeks. Endometrial adenocarcinoma was clearly suspected in this follow-up Pap smear and the case was subsequently investigated and confirmed as Endometrial carcinoma. This case is presented for its rarity of clinical features: younger age, absence of common risk factors, and early detection because of cervical cancer prevention programs. A review of the literature reveals the potential of curcumin and turmeric extracts in controlling gynaecological cancers.

Keywords


Pap Smears, Endometrial Carcinoma, Cervical Cancer Prevention, Cancer Screening, Risk Factors For Can-cer, Early Diagnosis Of Endometrial Adenocarcinoma.

References