Vita Giulia, Borgia Ludovica, Di Giovannantonio Luigina, Bisceglia Michele
Unit of Anatomic Pathology, IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero in Vulture (PZ), Italy.
Int J Surg Pathol. 2011 Oct;19(5):649-52. doi: 10.1177/1066896911405987. Epub 2011 Apr 28.
Dedifferentiation confers more aggressive malignant behaviour than would be otherwise shown by the original tumor if present alone. This phenomenon has been described in several tumors, both mesenchymal and epithelial. Dedifferentiated endometrioid carcinoma either ovarian or endometrial is the latest addition to this family of tumors. Only 2 papers have appeared in the literature so far on the topic of dedifferentiated endometrioid carcinoma, both from the same institution. We report herein a case of endometrial dedifferentiated endometrioid carcinoma in a 45-year old lady with ovarian metastasis from the undifferentiated component. The primary endometrial tumor showed an undifferentiated component in an otherwise low grade endometrioid carcinoma. The undifferentiated component of these tumors can be misdiagnosed as the solid component of FIGO grade 3 in a pure endometrioid carcinoma. The recognition of an undifferentiated component in an otherwise low grade endometrioid carcinoma is very important, since dedifferentiated endometrioid adenocarcinoma has a worse prognosis when compared with FIGO grade 3 endometrioid carcinoma.
去分化赋予肿瘤比单独存在的原始肿瘤更具侵袭性的恶性行为。这种现象已在多种肿瘤中被描述，包括间叶组织肿瘤和上皮组织肿瘤。去分化子宫内膜样癌，无论是卵巢的还是子宫内膜的，都是这类肿瘤中的最新成员。迄今为止，关于去分化子宫内膜样癌的主题，文献中仅出现了两篇论文，且均来自同一机构。我们在此报告一例45岁女性的子宫内膜去分化子宫内膜样癌，伴有来自未分化成分的卵巢转移。原发性子宫内膜肿瘤在其他方面为低级别子宫内膜样癌中显示出未分化成分。这些肿瘤的未分化成分可能会在纯子宫内膜样癌中被误诊为国际妇产科联盟（FIGO）3级的实性成分。认识到在其他方面为低级别子宫内膜样癌中存在未分化成分非常重要，因为与FIGO 3级子宫内膜样癌相比，去分化子宫内膜样腺癌的预后更差。
