Endometrial adenocarcinoma presenting in a premenopausal patient with tuberous sclerosis

BACKGROUND: Endometrial adenocarcinoma is very uncommon in women under 40 years of age. CASE: 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. CONCLUSION: Caregivers must pay particular attention to signs and symptoms in non-verbal patients. Persistent irregular bleeding on oral contraceptive therapy warrants additional evaluation.