Molecular classification of endometrial carcinoma (EC) has represented a breakthrough ever since the TCGA (The Cancer Genome Atlas) project published it in 2013. Four distinct molecular subgroups were recognized based on somatic copy number alterations and tumor mutational burden: POLE (polymerase-epsilon) ultramutated, MSI (microsatellite instability) hypermutated (MSI-H), copy number low (CNL) and copy number high (CNH). However, implementing a standardized algorithm in current practice is far from being definitive. Our purpose in this study was to determine different molecular subgroups in a cohort of Romanian patients using cost effective and available immuno-histochemistry markers and outline statistical associations with different parameters. Tissue microarrays encompassing 50 cases with previously diagnosed ECs were tested for ER, PR, HER2, p53, MSH6 and PMS2 and results showed 68% MSI-H cases with statistical correlation with tumor size ] 2 cm (p=0.028) and no association with overall survival. CNH ECs were reported in 26% of cases and showed important statistical significance with TILs (p=0.041) and no correlations with overall survival. The CNL subgroup was reported in 74% of ECs cases and showed statistical significance with the histopathological subtype (p=0.006), pT (removal of primary tumor according to AJCC/UICC convention) (p=0.033), risk category according to ESMO (European Society of Medical Oncology) criteria (p=0.022) and ER expression (p=0.002). Five-year overall survival was 84%. Molecular classification is an important additional tool in current pathology guidelines for reporting ECs, but it is not currently standardized or available in all laboratories. Its importance in evolving treatment strategies for this disease is well documented so we strongly recommend routine testing for molecular prognostic factors.

La bêta-caténine -un outil immunohistochimique important dans la stratification des carcinomes endométriaux?Introduction. Des recherches récentes ont montré que l'expression de la -caténine nucléaire immunohistochimique est un substitut valide pour la mutation de l'exon 3 CTNBB1 dans les carcinomes de l'endomètre (CE). Cette mutation est un facteur pronostique indépendant et identifie un sous-groupe de carcinomes de l'endomètre à bas degré qui ont une tendance à la récidive et à un pronostic défavorable. L'objectif de l'étude était d'évaluer l'expression de la -caténine nucléaire dans différents sous-groupes moléculaires de CE. Matériel et méthodes. Nous avons testé l'expression immunohistochimique de la -caténine nucléaire dans 50 cas de carcinomes de l'endomètre diagnostiqués dans deux unités cliniques. Une analyse statistique a ABSTRACTIntroduction. Recent research has demonstrated that the immunohistochemical nuclear -catenin expression is a valid surrogate for CTNNB1 exon 3 mutation in endometrial carcinomas (ECs). This mutation is an independent prognostic factor which identifies a subgroup of low-grade endometrial carcinomas that have a tendency for recurrence and worse prognosis. The objective of the study was to evaluate nuclear -catenin expression in different molecular subgroups of E Cs. Material and methods. We tested immunohistochemical nuclear -catenin expression in 50 cases of endometrial carcinomas diagnosed in two clinical institutions. Statistical analysis was performed between -catenin expression and various clinical, demographic, pathological and immunohistochemical parameters (age, myometrial invasion, FIGO grade, histopathological subtype, hormone receptors -ER, PR etc). Additionally, we analysed what molecular subgroup

Myofibroblastomes de type mammaire: rapport sur quatre cas avec accent sur le profil moléculaire et revue de la littérature Introduction. Les myofibroblastomes (MFB) du sein sont des lésions mésenchymateuses rares, supposées d'être dérivées d'une cellule stromale mammaire CD34-positive, présentant une grande capacité de multipotence. Rapport du cas. Nous avons mené une étude rétrospective sur 4 cas de myofibroblastomes mammaires confirmés entre 2003 et 2018. Des lames d'hématoxyline et d'éosine et des lames immunohistochimiques ont été passées en revue. Pour les études de séquençage de nouvelle génération, nous avons utilisé un panneau TruSight Tumor 15, qui fonctionnait dans un séquenceur MiSeq et qui a été analysé avec illumina Variant Studio 3.0 et VGI (Variation génomique intégrative). La série de cas comprenait 4 patients avec un rapport

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BACKGROUND. Primary sinonasal mucosal melanoma is a rare tumor with a poor survival rate. There is an inherent difficulty in diagnosing these lesions, especially because their complex anatomic locations and symptoms can be frequently confused with other benign or malignant processes. The purpose of our study was to report a difficult case and review the literature and recent research on therapeutic modalities. MATERIAL AND METHODS. We herein report a 61-year-old female patient, with a history of right eye enucleation and prosthesis, who presented with obstruction of the left nostril, anterior and posterior mucopurulent rhinorrhea, anosmia, left facial numbness, left exophthalmia accompanied by ipsilateral epiphora and decreased visual acuity. RESULTS. Clinical and imagistic testing revealed a large, grayish, fleshy tumor localized in the left maxillary sinus, with extension to the left orbit (producing osteolysis of the inferior and medial orbital walls), nasopharynx, ethmoidal cells and left frontal sinus. Pathological and immunohistochemical examination confirmed the diagnosis of mucosal melanoma. Other primary sites were excluded. The patient succumbed shortly after, following only palliative treatment. CONCLUSION. Early diagnosis of primary sinonasal mucosal melanoma is essential but very difficult to detect. Any symptoms such as unilateral epistaxis or nasal obstruction in a patient over the age of 60 should be rendered suspicious. Pathological and immunohistochemical examination for diagnosis and prognostic factors are important. Although surgery is the first option for treatment, one must consider, according to tumor staging, radiotherapy and chemotherapy with immunotherapy as a viable course of treatment for advanced cases.

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