Mrs. FD went through menopause ten years ago and has not experienced any menstrual bleeding until recently. She noticed light bleeding initially, which has become heavier over time. She also reports mild lower abdominal pain and bloating. She has a history of hypertension, which is well-managed with medication. Mrs. FD has no known family history of cancer. She has never had a Pap smear or other gynaecological screening.

Mrs. FD lives in an urban area of Bamako with her husband. She is a homemaker and has four adult children. She does not smoke or drink alcohol and follows a diet that is mostly high in carbohydrates and low in fresh fruits and vegetables. She has limited access to regular healthcare services.

On examination, Mrs. FD appears well but anxious. A pelvic examination reveals a slightly enlarged, non-tender uterus. There are no obvious signs of infection or other abnormalities on the external genitalia.

A transvaginal ultrasound reveals a thickened endometrium. An endometrial biopsy is performed and confirms the diagnosis of endometrial adenocarcinoma. A pelvic MRI shows that the cancer is confined to the uterus with no evidence of spread to other organs.

Early-stage endometrial adenocarcinoma.

1. Surgical Treatment:
- A total hysterectomy with bilateral salpingo-oophorectomy (removal of the uterus, fallopian tubes, and ovaries) is recommended as the primary treatment.
- Lymph node sampling may be performed during surgery to assess for any spread of the disease.
2. Adjuvant Therapy:
- Depending on the surgical findings, consider adjuvant radiation therapy to reduce the risk of recurrence, especially if there is evidence of lymph node involvement or other risk factors.

- Regular follow-up visits will be scheduled to monitor for any signs of recurrence.
- Postoperative care will include pain management, counselling, and support to help Mrs. Diallo adjust to life after surgery.