Table 1 A summary of the literature review findings for endometrioid carcinoma associated with pregnancy

The authors hypothesized that pregnancy may adversely affect the tumor growth; however, it cannot be proven because of the limited number of cases.

The authors opined that an immature, progesterone-unresponsive endometrium could be the possible mechanism of allowing endometrial carcinoma to develop in pregnancy.

The authors considered that the fate of the more advanced-stage tumors with deeper myometrial invasion or high-grade cytologic features may be less subject to the protective effects of gestational progesterone.

The authors cited a previous report which observed that hCG inhibits the DMBA-induced breast carcinogenesis in rats through an insulin-like growth factor-dependent mechanism.

The authors opined that in pregnancy-associated endometrial carcinoma, part of the lining undergoes gestational change, whereas another part becomes neoplastic. The portion of the endometrium which becomes neoplastic may be sensitive to estrogen, yet unresponsive to progesterone.

They concluded that with concomitant secretory endometrium, the malignant regions must be progesterone refractory.

The authors did not discuss the association between pregnancy and endometrioid carcinoma.

The authors concluded that the occurrence of postpartum EC was extremely rare probably due to the anti-tumor effects of progesterone.

The authors speculated that high progesterone levels during pregnancy may protect against EC.

The authors concluded that the anticancer effect of progesterone during pregnancy was in effect in these tumors.

The authors speculated that the presence of EC might have been related to a hypoxic damage of the chorionic villi. It might suggest a causal correlation between endometrial malignancy and spontaneous abortion.

The authors found that most case reports of first trimester EA are also reported as arising in a focal lesion.

Concurrent endometrial adenocarcinoma and an early pregnancy loss

The authors considered that EC associated with pregnancy were mostly in stages IA, and were histologically EAs.

Concurrent endometrial adenocarcinoma and an early pregnancy loss

The authors concluded that the routine histological examination of the curettage specimens for all first trimester abortions, independent of the age of the patient, should be encouraged.

The authors discussed that in a woman with progesterone-resistant endometrium, development of endometrial carcinoma could be potentiated by the relatively hyperestrogenic environment of early pregnancy and subsequently allowed to proliferate further due to a lack of response to progesterone.

The authors though that the presence of EC might have been related to the damage of the chorionic villi, suggesting a causal correlation between EC and spontaneous abortions.

Concurrent endometrial adenocarcinoma and an early pregnancy loss

Concurrent endometrial adenocarcinoma and an early pregnancy loss

The authors considered that the careful histological examination of the curettage specimens for all first trimester pregnancy losses should be encouraged.

Conservative management for EC in young women is possible including a case with an incidental diagnosis in pregnancy.