Practical issues in the diagnosis of serous carcinoma of the endometrium

Gatius, Sònia; Matías‐Guiu, Xavier

doi:10.1038/modpathol.2015.141

Cited by 37 publications

(28 citation statements)

References 79 publications

(67 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A diagnosis of mixed EEC-SC (about 70% of EAC and about 30% of serous adenocarcinoma) of the endometrium was made on the basis of morphology and immunohistochemistry, as previously published. [ 6 , 7 ] According to the staging criteria of FIGO 2009 for endometrial carcinoma and FIGO 2010 for endometrial stromal tumor, the patient was diagnosed with Federation International of Gynecology and Obstetrics (FIGO) stage IIIB endometrial stromal tumor and FIGO stage IA MT-EC.…”

Section: Case Presentationmentioning

confidence: 99%

Endometrial stromal sarcoma in combination with mixed type endometrial carcinomas

Xiu

Wang²,

Lv³

et al. 2017

Medicine

View full text Add to dashboard Cite

Rationale:Endometrial stromal sarcoma (ESS) is rare, representing only approximately 0.2% of all uterine malignancies. Mixed type endometrial carcinomas (MT-ECs) are rare tumors with both type I and II features, and are difficult to diagnose. Cases of ESS and MT-ECs coexisting in the same patient are extremely rare. This study aimed to describe a case of ESS in combination with MT-ECs in a 47-year-old premenopausal woman.Patient concerns:A woman presented to the hospital complaining of occasional abdominal pain and had high tumor markers: cancer antigen (CA) 19–9 (263.6 U/mL) and CA 125 (428.0 U/mL). Transvaginal ultrasound examination revealed a complex mass (12.3 × 9.1 × 6.3 cm) with solid and cystic components on the right rear wall of the uterus. Abdominopelvic computed tomography images showed a pelvic cystic-solid mixed mass. The patient underwent an exploratory midline laparotomy. The mass was hypothesized to be malignant on the uterine posterior wall. Tumor deposits were found on bilateral parametrium. On peritoneal implantation, multiple metastases were seen on the serosal surface of the bowel and greater omentum. A frozen section revealed a spindle cell sarcoma.Diagnoses:Pathological reports following surgery revealed concurrent ESS and MT-ECs.Interventions:The patient underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, total omentectomy, and macroscopic clearance of the tumor. Adjuvant chemotherapy was given.Outcomes:The patient was still alive when this report was written.Lessons:Considering the rarity of ESS in combination with MT-ECs, this study presented an overview of the literature and discussed a number of histological and clinical issues. Nevertheless, etiology and pathogenesis of these tumors need further investigation.

show abstract

Section: Case Presentationmentioning

confidence: 99%

Endometrial stromal sarcoma in combination with mixed type endometrial carcinomas

Xiu

Wang²,

Lv³

et al. 2017

Medicine

View full text Add to dashboard Cite

show abstract

“…The discrimination between high-grade endometrioid and serous endometrial cancer may be challenging, even with additional markers. 26 However, we do not think that this would have influenced outcome, because recurrence rates of early stage high-grade serous and high-grade endometrioid endometrial carcinoma are comparable 6 Still, this study does have some limitations. Due to the selected tumor type and risk group, the population size is rather limited, even in a large referral center over time.…”

Section: Discussionmentioning

confidence: 89%

Improved Outcome of High-Grade, Early 1-Stage Endometrioid Endometrial Carcinoma With Adjuvant Chemotherapy and Radiotherapy

Reynaers

Jutzi

Ezendam

et al. 2017

International Journal of Gynecological Cancer

View full text Add to dashboard Cite

show abstract

“…12,13 Besides, endometrioid carcinoma can sometimes display a papillary architecture with intermediate nuclear atypia which can be mistaken for serous carcinoma. 14,15 In addition, both high-grade endometrioid carcinoma and serous carcinoma can show solid areas, making it more difficult to differentiate between the two. Furthermore, serous carcinoma may rarely demonstrate a background of endometrial hyperplasia which could suggest a mixed endometrioid and serous differentiation.…”

Section: Introductionmentioning

confidence: 99%

Are the uterine serous carcinomas underdiagnosed? Histomorphologic and immunohistochemical correlates and clinical follow up in high-grade endometrial carcinomas initially diagnosed as high-grade endometrioid carcinoma

Hinson

Matnani

et al. 2018

Modern Pathology

View full text Add to dashboard Cite

Histologic subclassification of high-grade endometrial carcinomas can sometimes be a diagnostic challenge when based on histomorphology alone. Here we utilized immunohistochemical markers to determine the immunophenotype in histologically ambiguous high-grade endometrial carcinomas that were initially diagnosed as pure or mixed high-grade endometrioid carcinoma, aiming to determine the utility of selected immunohistochemical panel in accurate classification of these distinct tumor types, while correlating these findings with the clinical outcome. A total of 43 high-grade endometrial carcinoma cases initially classified as pure high-grade endometrioid carcinoma (n=32), mixed high-grade endometrioid carcinoma/serous carcinoma (n=9) and mixed high-grade endometrioid carcinoma/clear cell carcinoma (n=2) were retrospectively stained with a panel of immunostains, including antibodies for p53, p16, estrogen receptor, and mammaglobin. Clinical follow-up data were obtained, and stage-to-stage disease outcomes were compared for different tumor types. Based on aberrant staining for p53 and p16, 17/43 (40%) of the high-grade endometrial carcinoma cases initially diagnosed as high-grade endometrioid carcinoma were re-classified as serous carcinoma. All 17 cases showed negative staining for mammaglobin, while estrogen receptor was positive in only 6 (35%) cases. The remaining 26 cases of high-grade endometrioid carcinoma showed wild-type staining for p53 in 25 (96%) cases, patchy staining for p16 in 20 (77%) cases, and were positive for mammaglobin and estrogen receptor in 8 (31%) and 19 (73%) cases, respectively, thus the initial diagnosis of high-grade endometrioid carcinoma was confirmed in these cases. In addition, the patients with re-classified serous carcinoma had advanced clinical stages at diagnosis and poorer overall survival on clinical follow-up compared to that of the remaining 26 high-grade endometrioid carcinoma cases. These results indicate that selected immunohistochemical panel, including p53, p16, and mammaglobin can be helpful in reaching accurate diagnosis in cases of histomorphologically ambiguous endometrial carcinomas, and can assist in providing guidance for appropriate therapeutic options for the patients.

show abstract

Practical issues in the diagnosis of serous carcinoma of the endometrium

Cited by 37 publications

References 79 publications

Endometrial stromal sarcoma in combination with mixed type endometrial carcinomas

Endometrial stromal sarcoma in combination with mixed type endometrial carcinomas

Improved Outcome of High-Grade, Early 1-Stage Endometrioid Endometrial Carcinoma With Adjuvant Chemotherapy and Radiotherapy

Are the uterine serous carcinomas underdiagnosed? Histomorphologic and immunohistochemical correlates and clinical follow up in high-grade endometrial carcinomas initially diagnosed as high-grade endometrioid carcinoma

Contact Info

Product

Resources

About