Endometrial carcinoma: molecular subtypes, precursors and the role of pathology in early diagnosis

Endometrial carcinoma (EC) is classified into a wide range of morphological variants; this list has expanded over the past decade with inclusion mesonephric-like and dedifferentiated as EC variants in fifth edition WHO Classification Female Genital Tumours, recognition that carcinosarcoma biphasic rather than sarcoma. Each variant distinct molecular abnormalities, including TCGA-based subtypes, allowing further subclassification adding complexity. In contrast to rapid progress understanding EC, there are only two recognized precursor lesions: endometrial atypical hyperplasia/endometrioid intraepithelial neoplasia (EAH/EIN) serous carcinoma, situation not changed for many years. Diagnosis precursors cornerstone surgical pathology practice, early diagnosis contributing relatively favorable prognosis EC. review we relate lesions each discuss how successful variant/molecular subtype it might be improved, identify knowledge gaps where insufficient histogenesis. © 2020 The Pathological Society Great Britain Ireland. Published by John Wiley & Sons, Ltd.