Endometrial Carcinoma in a Patient with Type 2 Diabetes Mellitus: A Case Report
Case Report
DOI:
https://doi.org/10.55175/cdk.v53i05.1007Keywords:
Case report, diabetes mellitus, endometrial cancer, hyperinsulinemia, obesityAbstract
Introduction: Endometrial cancer is often associated with obesity, type 2 diabetes mellitus (T2DM), insulin resistance, and hyperinsulinemia. Case: A 71-year-old woman with a history of T2DM, hypertension, and obesity (body mass index/BMI 32.08 kg/m²) presented with intermittent abdominal pain and vaginal bleeding. She had undergone a curettage procedure two weeks earlier. Ultrasound examination revealed a hyperechoic mass in the uterine corpus, and histopathological examination following staging laparotomy confirmed type 2 endometrial carcinoma (high-grade serous carcinoma) with omental metastasis. The diagnosis was stage IVB endometrial carcinoma. During hospitalization, the patient received intravenous ceftriaxone, insulin glargine, and oral antihypertensive medications (ramipril and nifedipine). She was scheduled to receive systemic chemotherapy with carboplatin and paclitaxel, the standard regimen for advanced-stage, aggressive non-endometrioid endometrial cancer. Discussion: Diabetes mellitus, particularly when accompanied by chronic hyperglycemia, insulin resistance, and hyperinsulinemia, is associated with an increased risk of various cancers, including endometrial cancer, as well as a poorer prognosis. Factors such as obesity, age, estrogen exposure, and insulin therapy may exacerbate this risk, while biomarkers such as IGF-2 and IGFBP-3 have the potential to be used for early detection and risk assessment of endometrial cancer. Conclusion: This case highlights the strong link between T2DM, obesity, and aggressive endometrial cancer, emphasizing the importance of early detection and comprehensive management in patients with metabolic risk factors.
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References
Lortet-Tieulent J, Ferlay J, Dos-Santos-Silva I, Brinton LA, Negri E, Peeters PH, et al. International patterns and trends in endometrial cancer incidence, 1978–2013. J Natl Cancer Inst. 2017;110(4):354–61. doi: 10.1093/jnci/djx214.
Saed L, Varsi F, Aziziaram Z, Baradaran B, McDonagh M, Gheshlagh RG, et al. The effect of diabetes on the risk of endometrial cancer: an updated systematic review and meta-analysis. BMC Cancer. 2019;19(1):527. doi: 10.1186/s12885-019-5748-4.
Friberg E, Mantzoros CS, Wolk A. Diabetes and risk of endometrial cancer: a population-based prospective cohort study. Cancer Epidemiol Biomarkers Prev. 2007;16(2):276–80. doi: 10.1158/1055-9965.EPI-06-0763.
Luo J, Chlebowski R, Hendryx M, Rohan T, Wactawski-Wende J, Thomson CA, et al. Association between diabetes, diabetes treatment and risk of developing endometrial cancer. Br J Cancer. 2014;111(7):1432–9. doi: 10.1038/bjc.2014.407.
Anderson KE, Anderson E, Mink PJ, Hong CP, Sellers TA, Lazovich D, et al. Diabetes and endometrial cancer in the Iowa Women’s Health Study. Cancer Epidemiol Biomarkers Prev. 2001;10(6):611–6.
Rosato V, Zucchetto A, Bosetti C, Dal Maso L, Montella M, Pelucchi C, et al. Metabolic syndrome and endometrial cancer risk. Ann Oncol. 2011;22(4):884–9. doi: 10.1093/annonc/mdq464.
Koskas M, Amant F, Mirza MR, Creutzberg CL. Cancer of the corpus uteri: 2021 update. Int J Gynaecol Obstet. 2021;155(Suppl 1):45–60. doi: 10.1002/ijgo.13866.
PB Perkeni. Pedoman pengelolaan dan pencegahan diabetes melitus tipe 2 dewasa di Indonesia 2021. Jakarta: PB Perkeni; 2021.
Ramadhan N, Marissa N, Fitria E, Wilya V. Pengendalian diabetes melitus tipe 2 pada pasien di Puskesmas Jayabaru Kota Banda Aceh. Media Litbangkes. 2018;28(4):239–46. doi: 10.22435/mpk.v28i4.108.
Liao C, Zhang D, Mungo C, Tompkins DA, Zeidan AM. Is diabetes mellitus associated with increased incidence and disease-specific mortality in endometrial cancer? a systematic review and meta-analysis of cohort studies. Gynecol Oncol. 2014;135(1):163–71. doi: 10.1016/j.ygyno.2014.07.095.
Joung KH, Jeong JW, Ku BJ. The association between type 2 diabetes mellitus and women cancer: the epidemiological evidences and putative mechanisms. BioMed Res Int. 2015;2015:920618. doi: 10.1155/2015/920618.
Liang YJ, Hao Q, Zhang H, Wu YZ, Wang JD. Insulin-like growth factors in endometrioid adenocarcinoma: correlation with clinico-pathological features and estrogen receptor expression. BMC Cancer. 2012;12:262. doi: 10.1186/1471-2407-12-262.
Oh JC, Wu W, Tortolero-Luna G, Broaddus RR, Gershenson DM, Burke TW, et al. Increased plasma levels of insulin-like growth factor-2 and insulin-like growth factor binding protein-3 are associated with endometrial cancer risk. Cancer Epidemiol Biomarkers Prev. 2004;13(5):748–52.
Weiderpass E, Gridley G, Persson I, Nyren O, Ekbom A, Adami HO. Risk of endometrial and breast cancer in patients with diabetes mellitus. Int J Cancer. 1997;71(3):360–3. doi: 10.1002/(sici)1097-0215(19970502)71:3<360::aid-ijc10>3.0.co;2-v.
Habib SL, Rojna M. Diabetes and risk of cancer. ISRN Oncol. 2013;2013:583786. doi: 10.1155/2013/583786.
Jonasson JM, Ljung R, Talback M, Haglund B, Gudbjornsdottir S, Steineck G. Insulin glargine use and short-term incidence of malignancies-a population-based follow-up study in Sweden. Diabetologia. 2009;52(9):1745–54. doi: 10.1007/s00125-009-1444-2.
Janghorbani M, Dehghani M, Salehi-Marzijarani M. Systematic review and meta-analysis of insulin therapy and risk of cancer. Horm Cancer. 2012;3(4):137–46. doi: 10.1007/s12672-012-0112-z.
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