Uterine Cancer (Endometrial Carcinoma): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin and mucous membranes
      • Abdominal wall and inguinal region (groin area).
  • Gynecological examination
    • Inspection
      • Vulva (external, primary female sexual organs).
      • Vagina (vaginal) [in rare cases, metastases/daughter tumors are possible in the vagina]
      • Cervix uteri (cervix), or portio (cervix; transition from cervix uteri to vagina (vagina)) [Bleeding ex utero/from the uterus; uterine fluorine – vaginal discharge originating in the uterus, may occur with advanced endometrial cancer], taking a Pap smear (for early detection of cervical cancer), and performing a dash curettage (to detect endometrial cancer).
    • Palpation (bimanual; palpation with both hands) of the internal genital organs.
      • Cervix uteri [may be distended; in approximately 10% of cases, there may be continuous growth into the cervix uteri; this may also lead to obstruction of the cervical canal, resulting in hematometra/accumulation of blood in the uterus]
      • Uterus (uterus) [Normal: anteflexed/angled forward, normal size, no tenderness; hematometra (see above), when infected may result in infected pyometra/accumulation of pus in the uterus; in approximately 10% of cases, growth may cause the uterine boundaries to be exceeded]
      • Adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tubule (fallopian tube)) [Normal: free]
      • Parametria (pelvic connective tissue in front of the cervix to the urinary bladder and on both sides to the lateral pelvic wall) [Normal: free; infiltration of the parametria is possible]
      • Pelvic walls [Normal: free; infiltration into the lesser pelvis is possible]
      • Douglas space (pocket-like bulge of the peritoneum (abdominal wall) between the rectum (rectum) posteriorly and the uterus (uterus) anteriorly) [Normal: clear]
    • Inspection of the mammae (breasts), right and left; nipple (breast), right and left; and skin [Normal: unremarkable].
    • Palpation of the mammae, both supraclavicular pits (upper clavicular pits), and axillae (axillae) [Normal: unremarkable].
  • Health check (as an additional follow-up measure).

Square brackets [ ] indicate possible pathological (pathological) physical findings.