Evanescence of Endometrial Carcinomas in Hysterectomy Specimens: Observations on the “Vanishing Cancer” Phenomenon

Bharani, Vani; Rai, Bhavana; Rajwanshi, Arvind; Gupta, Nalini; Dey, Pranab; Kalra, Jaswinder; Suri, Vanita; Srinivasan, Radhika

doi:10.1177/1066896918783581

Cited by 4 publications

(14 citation statements)

References 7 publications

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“…After excluding the 3 patients who had pre-operative radiation therapy or had lymph node metastasis, 17 patients met criteria of vanishing EMC. Despite of more rigid criteria, our 3.8% prevalence was still higher than two previous reports which found 1.6% and 2.4% of vanishing cancer in 1567 and 320 EMC patients respectively [12,13].…”

Section: Discussioncontrasting

confidence: 84%

“…One may question about the adequacy of sections especially if no/ minimal/ microscopic cancer was remained. Few previous reports provided some related information [11,13]. Bharani et al [13] described serial 2-3 mm interval of pathologic sectioning of uterine specimen; however, the number of tissue sections embedded was not given.…”

Section: Discussionmentioning

confidence: 99%

“…Few previous reports provided some related information [11,13]. Bharani et al [13] described serial 2-3 mm interval of pathologic sectioning of uterine specimen; however, the number of tissue sections embedded was not given. Another study by Ahmed et al, who also processed 2-3 mm interval of their pathologic sectioning, reported total retrieved number of 4-54 sections [11].…”

Section: Discussionmentioning

confidence: 99%

“…This was possible especially when there was only small volume of lesion. We collected data from 69 patients from 4 previous studies of vanishing cancer of EMC including 17 patients in our study (Table 2) [6,[11][12][13]. Majority (75 out of 86 patients or 87%) had pre-operative curettage procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors proposed criteria for a diagnosis of vanishing cancer: there was no residual tumor in the hysterectomy specimen, no prior treatment for cancer, and the diagnosis of EMC must be confirmed from a pathological review of pre-operative tissue [6]. There had been few case reports of vanishing cancer in prostate [7][8][9], thyroid [10], and endometrium [6,[11][12][13]. Few underlying reasons had been proposed.…”

Section: Introductionmentioning

confidence: 99%

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Clinico-pathological aspects of vanishing endometrial cancer

Srijaipracharoen¹,

Tangjitgamol²

2020

Clin Obstet Gynecol Reprod Med

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Aims: To assess the prevalence, pre-operative findings, and clinical outcomes of endometrial cancer (EMC) patients who had vanishing cancer. Methods:Patients who had pre-operative tissue diagnosis of EMC, and had surgical treatment including hysterectomy in the institution between 1995 and 2015 were identified. The patients who had no residual carcinoma in all pathologic specimens including the uterus were included. Pre-and post-operative clinico-pathological data were collected. Clinical outcomes including recurrence and survival of the patients were studied.Results: Among 422 patients who had tissue diagnosis of endometrial cancer, twenty patients had no residual cancer in the hysterectomy specimens. Three patients who had pre-operative radiation therapy or had evidence of endometrial cancer outside the uterus were excluded, so 17 patients (3.8%) were diagnosed as having vanishing cancer. One of the 17 patients, who had pre-operative endometrioid endometrial cancer, had adjuvant chemotherapy for synchronous serous carcinoma of fallopian tube. From a follow-up period of 62.7 months (range, 6.8-184.4 months), no recurrences were found. Only 2 patients were dead of other diseases. Conclusion:Patients with vanishing endometrial cancer had excellent prognosis. Adjuvant treatment may not be needed. However, periodic surveillance was still recommended because data were derived from only small number of patients.

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Section: Discussioncontrasting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinico-pathological aspects of vanishing endometrial cancer

Srijaipracharoen¹,

Tangjitgamol²

2020

Clin Obstet Gynecol Reprod Med

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Analysis of vanishing endometrial cancer by pathological types

Görgülü

Özdaş

et al. 2022

J of Obstet and Gynaecol

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Purpose: We asked why endometrial cancer sometimes vanishes. Methods: A total of 454 patients diagnosed with endometrioid-type endometrial cancer (EC) (via endometrial sampling) and treated in our clinic over the past 5 years were enrolled. The patients were divided into two groups: vanishing and residual, depending on whether a tumor was detected in the postoperative hysterectomy specimen. Patient age, numbers of pregnancies and deliveries, menopausal status, systemic disease status, hemogram parameters, International Federation of Gynecology and Obstetrics (FIGO) grade, and invasion status (evident on magnetic resonance imaging [MRI]) were compared between the groups. Results: ECs vanished in 42 (9.25%) patients. The vanishing rates were 19.7% (37/187) in FIGO grade 1 patients, 2.1% (5/238) in grade 2 patients, and 0% (0/29) in grade 3 patients. The average age was lower in the vanishing than the residual group, but the premenopausal status and grade 1 tumor rates were higher (both p < 0.001). An absence of invasion (as revealed by MRI) was more common in the vanishing group (p < 0.001). No recurrence developed in the vanishing group, but recurrences were noted in 3.3% (14/412) of the residual group. There were no significant between-group differences in any of the numbers of pregnancies or births, systemic disease status, or hemogram parameters (all p > 0.05). Conclusion:Vanishing EC is more likely in premenopausal women with endometrioid grade 1 EC (as revealed by endometrial biopsy) who lack myometrial invasion on MRI.

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Oncological safety of hysteroscopy in endometrial cancer

Quintana-Bertó¹,

Padilla-Iserte

Oliver-Pérez

et al. 2022

Int J Gynecol Cancer

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ObjectiveIt has been suggested that the manipulation of neoplastic tissue during hysteroscopy may lead to dissemination of tumor cells into the peritoneal cavity and worsen prognosis and overall survival. The goal of this study was to assess the oncological safety comparing hysteroscopy to Pipelle blind biopsy in the presurgical diagnosis of patients with endometrial cancer.MethodsWe performed a retrospective multicentric study among patients who had received primary surgical treatment for endometrial cancer. A multivariate statistical analysis model was used to compare relapse and survival rates in patients who had been evaluated preoperatively either by hysteroscopy or Pipelle biopsy. The relapse rate, disease-free survival, and overall survival were assessed as the main outcomes. The histological type, tumor size, myometrial invasion, International Federation of Gynecology and Obstetrics (FIGO) stage, surgical approach, use of a uterine manipulator, and adjuvant treatment were also included in the analysis.ResultsA total of 1731 women from 15 centers were included: 1044 in the hysteroscopy group and 687 in the Pipelle sampling group. 225 patients relapsed during the 10 year follow-up period: 139 (13.3%) in the hysteroscopy group and 86 (12.4%) in the Pipelle sampling group. There is no evidence of an association between the use of hysteroscopy as a diagnostic method and relapse rate (HR 1.24, 95% CI 0.92 to 1.66; p=0.16), lower disease-free survival (HR 1.23, 95% CI 0.92 to 1.66; p=0.15), or overall survival (HR 0.95, 95% CI 0.70 to 1.29; p=0.76).ConclusionHysteroscopy is a safe diagnostic method for patients with endometrial cancer with no impact on oncological outcomes when compared with sampling by Pipelle.

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Evanescence of Endometrial Carcinomas in Hysterectomy Specimens: Observations on the “Vanishing Cancer” Phenomenon

Abstract: The recognition of "vanishing endometrial carcinoma" as a distinct entity is of utmost importance to avoid mislabeling them as medical errors.

Cited by 4 publications

References 7 publications

Clinico-pathological aspects of vanishing endometrial cancer

Clinico-pathological aspects of vanishing endometrial cancer

Analysis of vanishing endometrial cancer by pathological types

Oncological safety of hysteroscopy in endometrial cancer

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