Fig. 126.—Nodular form of cancer of the body of the uterus.
In the later stages of the disease the whole body of the uterus becomes infiltrated. The endometrium is destroyed. The cancerous masses ulcerate and break down. The peritoneal covering is for a certain time a barrier to the extension of the disease. In many cases the whole of the body of the uterus may be infiltrated with cancer, and yet the peritoneum will remain intact. The accompanying illustration ([Fig. 127]) shows this: the infiltration extends to, but does not involve, the peritoneum.
Fig. 127.—Cancer of the body of the uterus: a large single cancerous nodule (c) in the anterior wall has been divided.
Later, however, the peritoneum, the Fallopian tubes, and the ovaries become involved. Intestinal adhesions are formed, and the disease may extend throughout the abdominal cavity. The cervix and the vagina may be attacked by extension from above, though, on the other hand, the disease may progress sufficiently to destroy life, and yet the cervix may remain unaffected.
Metastasis may take place by way of the lymphatics. Extension by metastasis, however, is unusual.
Cancer of the body of the uterus occurs at a somewhat later age than cancer of the cervix. The average age is between fifty and sixty. The disease attacks both the parous and nulliparous woman, the latter perhaps more often than the former.
The causes of cancer of the body of the uterus are unknown. It is probable that the various forms of endometritis, by diminishing the resistance of the endometrium, predispose to the development of cancer. It has been maintained that fibroid tumors of the uterus, as a result of the accompanying alterations in the endometrium, predispose to cancer. Cancer of the endometrium is certainly not infrequently found in uteri containing fibroid tumors.
