Endometrioid adenocarcinoma with simultaneous endocervical and intestinal-type mucinous differentiation: report of a rare phenomenon and the immunohistochemical profile

Buell-Gutbrod, Rebecca; Sung, C. James; Lawrence, W. Dwayne; Quddus, M. Ruhul

doi:10.1186/1746-1596-8-128

Cited by 23 publications

(30 citation statements)

References 12 publications

(13 reference statements)

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“…If the tumor were mucinous, it might be very difficult to distinguish between colonic origin or the female genital tract [9][10][11][12]. In the immunohistochemistry, it could have presented CK7 positive and CK20 negative even if it was from colonic origin [13], but our patient presented the most common profile in colon cancer (CK7 negative and CK20 positive).…”

Section: Discussionmentioning

confidence: 76%

Uterine metastasis from the rectosigmoid transition cancer: a case report

Henn¹,

Zanin²,

Oliveira³

et al. 2017

J Histol Histopathol

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Colorectal Cancer is common and it will often present with metastases during the course of the disease and follow-up. Usually metastasis affects liver and lungs, but other organs may also be involved. We report the case of a patient who had cancer in the recto-sigmoid transition in 2002 and had a recurrence 14 years after surgery with metastasis in the uterine body. The patient had the tumor resected and was given adjuvant chemotherapy. It is important to consider this possibility in patients with prior history of neoplasm that presents with abnormal vaginal bleeding.

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Section: Discussionmentioning

confidence: 76%

Uterine metastasis from the rectosigmoid transition cancer: a case report

Henn¹,

Zanin²,

Oliveira³

et al. 2017

J Histol Histopathol

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“…AEH was detected in the background endometrium of two cases: one a mixed form, while it was unclear if an endometrioid component was present in the second case. In both patients, no IM/diff was found in benign glands [11,13]. Alternative pathogenic mechanisms and precursors beside AEH may be considered for pure forms: the tumor reported by Rubio arose after previous removal of an endometrial polyp with IM/diff, and AEH was not found in the background endometrium [14].…”

Section: Discussionmentioning

confidence: 87%

“…Finally, seven studies were included in the review, for a total of nine patients diagnosed with EC with IM/diff including the case reported by us. Table 2 summarizes the clinical and pathological features, treatment modalities, and outcomes of all published cases of primary ECs with IM/diff [9][10][11][13][14][15][16]. Mean and median age were respectively 64 and 62 years (range 49-81 years).…”

Section: Literature Reviewmentioning

confidence: 99%

“…Intestinal type metaplasia/differentiation (IM/diff) in EC was first described by Berger in 1984 [10]. Since then, it has been exceptionally reported in pure forms or in association with endometrioid carcinomas [11]; for its rarity, clinical implications are unclear. We performed a systematic literature review to provide additional clinico-pathological information helpful in understanding this unusual finding and we discussed the spectrum of differential diagnoses (including primary and secondary endometrial tumors with intestinal/intestinal-like features) and possible pathogenic hypotheses.…”

Section: Introductionmentioning

confidence: 99%

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Endometrial Carcinomas with Intestinal-Type Metaplasia/Differentiation: Does Mismatch Repair System Defects Matter? Case Report and Systematic Review of the Literature

Ardighieri

Palicelli

Ferrari

et al. 2020

JCM

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Background: Intestinal metaplasia/differentiation in primary endometrial carcinomas is an uncommon phenomenon, with only few cases described. Material and Methods: We performed a systematic review of endometrial carcinomas with intestinal metaplasia/differentiation interrogating the electronic databases Pubmed, Web of Science, and Scopus, and we reported an additional case arising in a 49-year-old woman. Results: We identified only eight patients diagnosed with endometrial carcinomas exhibiting intestinal metaplasia/differentiation, and additionally our case. Endometrial carcinomas with intestinal-type features can present in pure or mixed forms in association with usual-type endometrioid carcinomas; in mixed forms, the two neoplastic components may derive from a common neoplastic progenitor, as evidenced by the concomitant loss of MSH2 and MSH6 protein expression in our case. Disease recurrences occur in a significant fraction of the cases, including patients diagnosed in low-stage disease. Conclusions: Endometrial carcinomas with intestinal metaplasia/differentiation are rare and they may represent a more aggressive tumor variant, thus requiring a proper treatment despite the low-tumor stage. The ProMise classification should be performed also in these unusual tumors, since they can be associated with mismatch repair system defects.

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“…In the present case, neither lesion, IM in the polyp nor adenocarcinoma, had an endometrioid carcinoma phenotype but expressed CDX2, villin, and MUC2, as well as concurrent staining of gastric-type mucins MUC5AC and MUC6, confirming their full gastrointestinal phenotype. Intestinaltype mucinous endometrial carcinoma is equally exceptional, having been reported only twice (9,10). Neither of these previously described cases was associated with PM and in both, diagnoses were based on histologic findings but not on the finding of a gastrointestinal immunophenotype.…”

Section: Discussionmentioning

confidence: 92%

Pseudomyxoma-type Invasion in Gastrointestinal Adenocarcinomas of Endometrium and Cervix

Rubio

Schuldt

Guarch

et al. 2016

International Journal of Gynecological Pathology

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This paper presents a clinicopathologic and immunohistochemical report of 2 gastrointestinal-type tumors, one in the endometrium and the other in the cervix. Both showed extensive invasion into the pelvic structures with acellular mucin, identical to pseudomyxoma but in the absence of appendiceal or ovarian tumors. Case 1 was an 81-yr-old female with a Stage III endometrial gastrointestinal-type adenocarcinoma who had had an endometrial polyp with intestinal metaplasia 4 years previously. Case 2 was a 68-yr-old female with Stage IIIB endocervical gastrointestinal-type adenocarcinoma. Both were associated with a pseudomyxoma type of invasion, which in the endometrial case was transmural through the myometrium, and in the cervical case involved parametria, pelvic floor, and lymph nodes. Immunohistochemically, both tumors had a gastrointestinal phenotype coexpressing cytokeratins 7 and 20, CDX2, villin, MUC2, MUC5AC, and MUC6 and were negative for human papillomavirus, analyzed by real-time polymerase chain reaction. The first case exemplifies intestinal endometrial metaplasia as a precursor lesion of the rare gastrointestinal type of adenocarcinoma and also proves its progression into carcinoma. The second case exemplifies the highly aggressive nature of cervical invasion forming mucin lakes. Extensive pseudomyxoma in the uterus and cervix was associated with high clinical stages with marked lymphovascular invasion and lymph node metastases.

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Endometrioid adenocarcinoma with simultaneous endocervical and intestinal-type mucinous differentiation: report of a rare phenomenon and the immunohistochemical profile

Cited by 23 publications

References 12 publications

Uterine metastasis from the rectosigmoid transition cancer: a case report

Uterine metastasis from the rectosigmoid transition cancer: a case report

Endometrial Carcinomas with Intestinal-Type Metaplasia/Differentiation: Does Mismatch Repair System Defects Matter? Case Report and Systematic Review of the Literature

Pseudomyxoma-type Invasion in Gastrointestinal Adenocarcinomas of Endometrium and Cervix

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