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This is a classic endometrioid adenocarcinoma with confluent gland pattern, FIGO grade 1, nuclear grade 1.
It is true sometimes it is difficult to differ the low grade endometrioid ca from atypical complex hyperplasia and the hysterectomy is most common choice for the older women with ACH. However the concepts of cancer and hyperplasia are different. The cancer can cause more psychologic pressure to the patients.