A Rare Case of Poorly-Differentiated Endometrial Carcinoma in a Female-to-Male Transgender Man on Testosterone Therapy

This case report describes a 56-year-old female-to-male transgender man on long-term testosterone and finasteride therapy who developed poorly-differentiated endometrial carcinoma. Despite no history of abnormal pap smears, the patient presented with vaginal discharge, and subsequent imaging and biopsy revealed a significant endometrial mass. The patient underwent a hysterectomy, and the tumor showed extensive necrosis and specific immunohistochemical staining patterns. The case highlights the need for ongoing gynecologic care in transgender men on testosterone therapy, as the long-term effects on endometrial pathology, including malignancy risk, are not well understood.