Sertoliform Endometrial Adenocarcinoma

Eichhorn, John H.; Young, Robert H.; Clement, Philip B.

doi:10.1097/00004347-199604000-00005

Cited by 43 publications

(21 citation statements)

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“…Because both UTROSCTs and cervical adenocarcinomas may stain for cytokeratin cocktail and CK7, and both mesonephric adenocarcinomas and UTROSCTs may express inhibin and calretinin, other immunohistochemical markers such as EMA and desmin may help in making this distinction (8)(9)(10). As in this case, EMA is generally negative in UTROSCTs (11)(12)(13), but is positive in most adenocarcinomas (5,7,10). In contrast, desmin has been reported to be positive in many UTROSCTs (11,14), but should be absent in a sertoliform endometrioid adenocarcinoma (7).…”

Section: Discussionsupporting

confidence: 60%

“…Mesonephric adenocarcinoma may have a variety of histopathologic patterns including ductal, nested, tubular, retiform, sex-cord-like, and sarcomatoid (5). Rarely, endometrioid adenocarcinomas also may have a sex-cord-like or sertoliform pattern (6,7). Differentiating between these tumors and a UTROSCT in a small sample may be difficult, although in this case the paucity of mitotic figures and the bland nuclear features argued against adenocarcinoma.…”

Section: Discussionmentioning

confidence: 86%

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Uterine Tumor Resembling Ovarian Sex-cord Tumor

Kabbani

Deavers

Malpica

et al. 2003

International Journal of Gynecological Pathology

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Uterine tumors resembling ovarian sex-cord tumors (UTROSCTs) are unusual neoplasms with histologic features that resemble those within ovarian Sertoli and granulosa cell tumors. We report the case of a 24-year-old woman with a UTROSCT presenting as a cervical mass, which on initial evaluation was thought to represent cervical adenocarcinoma. The patient's cervical biopsy specimen contained epithelioid cells arranged in tubules and anastomosing cords, without significant cellular atypia or mitotic activity. Because this morphology elicited a broad differential diagnosis, immunohistochemical studies were performed. The tumor was found to be diffusely positive for cytokeratin cocktail, calretinin, and desmin, focally positive for CK7 and SMA, and negative for EMA, CEA, inhibin, CD10, CK20, chromogranin, and synaptophysin. Ultrastructural examination revealed occasional gland-like lumens with cells joined by desmosomes and a continuous basal lamina. UTROSCTs have features that may cause them to be confused with more common tumors, especially in limited biopsy samples, and should be included in the differential diagnosis when a gland-forming neoplasm with an unusual appearance is identified in a cervical or endometrial biopsy specimen.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 86%

Uterine Tumor Resembling Ovarian Sex-cord Tumor

Kabbani

Deavers

Malpica

et al. 2003

International Journal of Gynecological Pathology

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“…24,31,42,43,50 A few examples of sertoliform ECs have also been described in the endometrium. 20,48 Another unusual finding in ECs, one that may cause confusion with a malignant mullerian mixed tumor (MMMT), is the presence of spindled epithelial cells. ECs with spindle cells have been encountered in the ovary, 47 but similar tumors have also been documented in other sites such as the endometrium 15 and fallopian tube.…”

mentioning

confidence: 99%

Endometrioid Carcinomas of the Uterine Corpus With Sex Cord-like Formations, Hyalinization, and Other Unusual Morphologic Features

Murray

Clement²,

Young³

2005

American Journal of Surgical Pathology

110

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We describe a series of unusual endometrioid carcinomas (ECs) of the uterine corpus characterized in significant part by cords of epithelioid cells, spindle cells, and a hyalinized stroma that sometimes formed osteoid. These features, particularly when prominent, produced an appearance strikingly different from that of conventional EC, sometimes resulting in problems in differential diagnosis, especially with a malignant mullerian mixed tumor (carcinosarcoma). The 31 patients ranged in age from 25 to 83 years (mean, 52 years). The proportion within each stage were as follows: stage Ia, 9.7%, stage Ib, 45.2%, stage Ic, 9.7%, stage IIb, 16.1%, stage IIIc 3.2%, and stage IV, 3.2%. In 4 patients (12.9%), staging information was not available. On microscopic examination, typical EC, which accounted for 10% to 90% of the tumor, was admixed in 90% of cases with cords of epithelioid or spindle cells within a hyalinized stroma. In 3 cases, the tumor contained cords of cells without a hyalinized stroma. Areas with a diffuse growth of fusiform cells suggesting endometrial stromal cells were also occasionally seen in minor amounts. Seventy percent of the tumors exhibited squamous differentiation, and in 50% of the tumors there was a background of endometrial hyperplasia. Two thirds of the tumors were grade 2 and the remainder were grade 1. Vascular space invasion was identified in seven tumors. On immunohistochemical analysis, the typical EC component was strongly positive for keratin, whereas the keratin staining was more focal and variable in the epithelial cells in the cords. Muscle markers (desmin, actin), CD10, and inhibin were negative in the latter. Overexpression of p53 was found in only 1 case. Eighty-three percent of the patients were alive with no evidence of disease on follow-up (range, 2-115 months; mean, 34.4 months). The clinical features, including a typically low stage and generally good prognosis, and histologic findings are different from those of malignant mullerian mixed tumors that are characterized by both high-grade carcinomatous and sarcomatous components and an aggressive clinical course. Confusion with other neoplasms, particularly those with sex cord-like growth, such as uterine tumors resembling ovarian sex cord tumors and epithelioid smooth muscle tumors, may also arise. We refer to tumors with the features described herein as "corded and hyalinized endometrioid carcinomas," a designation that reflects their two most striking and consistent features. Corded and hyalinized endometrioid carcinomas are yet another example of the protean phenotype of endometrioid adenocarcinomas of the female genital tract that has been appreciated only in the last two decades.

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“…SEC is a rare variant of endometrioid adenocarcinoma, most of which were reported in the ovary and rare cases in the endometrium (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). It causes important diagnostic difficulties for the pathologist due to its morphologic resemblance to sex cord stromal tumors, especially sertoli cell tumor and sertoli leydig cell tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Then Fox et al defined the first case of endometrium (3) and to date, nearly 80 cases of the ovary (1, 2, 4-9) and nearly 20 cases of the endometrium (3,10,(11)(12)(13)(14) were reported in the literature. Its morphologic similarity to sex cord stromal tumors such as sertoli cell tumor, sertoli-leydig cell tumor or rarely granulosa cell tumor causes diagnostic pitfall for the pathologist.…”

Section: Sertoliform Endometrioid Carcinomamentioning

confidence: 99%

Ovarian sertoliform endometrioid adenocarcinoma: A rare variant which causes diagnostic pitfalls

Kankaya¹,

Kahraman²,

Ortaç³

et al. 2015

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Sertoliform endometrioid carcinoma (SEC) is a rare variant of endometrioid adenocarcinoma, which causes diagnostic pitfalls due to its morphologic resemblance of sex cord stromal tumors. Herein, we report a case of SEC in the ovary almost all of which consisted of sex-cord like areas and was presumed to be a sertoli cell tumour initially. Immunohistochemical features incompatible with sertoli cell tumour were alerting and extensive sampling revealed a focal component of classical endometrioid carcinoma with anastomosing cribriform areas of more columnar cells. The final diagnosis was sertoliform endometrioid adenocarcinoma. This entity should be kept in mind for all the pathologists and gynaecologic oncologists. Sampling such tumours extensively and confirming the diagnosis by immunohistochemistry using a large antibody panel is requisite for the correct diagnosis and preventing the patient from inappropriate therapies.

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Sertoliform Endometrial Adenocarcinoma

Cited by 43 publications

References 0 publications

Uterine Tumor Resembling Ovarian Sex-cord Tumor

Uterine Tumor Resembling Ovarian Sex-cord Tumor

Endometrioid Carcinomas of the Uterine Corpus With Sex Cord-like Formations, Hyalinization, and Other Unusual Morphologic Features

Ovarian sertoliform endometrioid adenocarcinoma: A rare variant which causes diagnostic pitfalls

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