title: Endometrial adenocarcinoma presenting in a premenopausal patient with tuberous sclerosis.
abstract: BACKGROUND
  Endometrial adenocarcinoma is very uncommon in women under 40 years of age.
  
  
  METHODS
  A 39-year-old woman with tuberous sclerosis and severe intellectual disability presented with irregular bleeding unresponsive to oral contraceptive therapy. She was subsequently found to have a deeply invasive endometrial adenocarcinoma.
  
  
  CONCLUSIONS
  Caregivers must pay particular attention to signs and symptoms in non-verbal patients. Persistent irregular bleeding on oral contraceptive therapy warrants additional evaluation.
authors.affiliation: Sharon Hospital, Sharon, CT 06069, USA. jjaffe@snet.net
authors.forename: J S
authors.initials: JS
authors.lastname: Jaffe
authors.forename: J T
authors.initials: JT
authors.lastname: Chambers
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D017697:Premenopause; D014402:Tuberous Sclerosis / Q000235:genetics* / Q000503:physiopathology