The determination of the malignancy of an endometrioid adenocarcinoma arising in the lower uterine segment (LUS) is diffıcult because of the high degree of differentiation of adenocarcinoma. The cytopathological and immunohistochemical features of endometrioid adenocarcinoma arising in the LUSThe uterine lining is anatomically divided into two regions: the mucosa of the lower uterine segment (LUS) and the corpus mucosa proper, the former being thinner than the latter. 1,2 In the LUS mucosa, glands often contain ciliated cells and show a gradual transition to endocervical glands, and the stroma is more fibrous than the cellular stroma of the corpus mucosa proper. Both glands and stroma of this portion tend to respond weakly to hormonal stimulation. 3 According to Hachisuga et al., 3 in a comparison with common endometrial tumors of the corpus, tumors of the LUS tended to be high-grade adenosquamous carcinomas, and myometrial invasion was more extensive. The LUS bridges the endocervix and the uterine corpus with a gradual transition between the two sites, resulting in a hybrid appearance in the glands and stroma of this region. 4 The short-term follow-up revealed that LUS tumors, which were known to be p53-positive and estrogen receptor (ER)-and progesterone (PR)-negative, endometrioid adenocarcinoma was categorized in estrogen-unrelated tumors, carried an unfavorable prognosis. [5][6][7] In the case of minimal-deviation adenocarcinoma (MDA) of the cervix, the cells lining the glands lack cytological features of malignancy. 8 In this connection, we present the clinicopathological and immunohistochemical features of a young patient with endometrioid adenocarcinoma accompanying squamous metaplasia arising in the LUS. The cytological and immunohistochemical characteristics are discussed in light of their malignancy and/or borderline findings.
Case ReportA 27-yr-old female presented at our hospital with the complaint of abdominal pain, which was diagnosed as hemorrhagic infarct due to ovarian torsion of the right ovary.
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