Yiğit Seyran, Ekinci Neşe, Hayrullah Leyla, Öcal İrfan, Bezircioğlu İncim
Department of Pathology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
Department of Obstetrics and Gynecology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
J Turk Ger Gynecol Assoc. 2018 Aug 6;19(3):132-136. doi: 10.4274/jtgga.2017.0090. Epub 2018 Mar 16.
Dedifferentiated endometrioid adenocarcinoma is a recently defined uterine tumor composed of low-grade endometrioid adenocarcinoma and undifferentiated carcinoma. Herein, we present clinicopathologic, morphologic, and immunohistochemical features of 5 cases of dedifferentiated endometrioid adenocarcinoma.
All cases which were diagnosed as mixed endometrial adenocarcinoma (endometrioid+undifferentiated carcinoma) or dedifferentiated endometrioid adenocarcinoma between January 2008 and December 2014 were retrieved from the archives of our institution’s pathology department.
The median age of the patients was 58 years. Polypoid growth pattern was seen in 3 patients and 2 were diagnosed at advanced stage. All patients received either external radiotherapy, brachytherapy, chemotherapy or an appropriate combination according to the stage. Only one patient died of the disease. Microscopically, there was a sharp demarcation between the two tumor components. The undifferentiated carcinoma component was composed of diffuse sheets of monomorphic cells lacking any differentiation. Focal pleomorphism and rhabdoid features were also noted. The undifferentiated carcinoma component was variably positive for PAX-8, cytokeratin, EMA, estrogen receptor, and neuroendocrine markers.
Misdiagnosis of undifferentiated carcinoma in dedifferentiated endometrioid adenocarcinoma as grade 3 endometrioid adenocarcinoma is not uncommon. The recognition of morphologic and immunohistochemical features of this newly described entity is crucial because it alters treatment and prognosis.
去分化子宫内膜样腺癌是一种最近定义的子宫肿瘤，由低级别子宫内膜样腺癌和未分化癌组成。在此，我们呈现5例去分化子宫内膜样腺癌的临床病理、形态学及免疫组化特征。
从我院病理科存档中检索出2008年1月至2014年12月期间诊断为混合性子宫内膜腺癌（子宫内膜样+未分化癌）或去分化子宫内膜样腺癌的所有病例。
患者的中位年龄为58岁。3例患者表现为息肉样生长模式，2例在晚期被诊断。所有患者均根据分期接受了外照射放疗、近距离放疗、化疗或适当的联合治疗。仅1例患者死于该疾病。显微镜下，两种肿瘤成分之间有明显界限。未分化癌成分由缺乏任何分化的单形性细胞弥漫性片状构成。还注意到局灶性多形性和横纹肌样特征。未分化癌成分对PAX-8、细胞角蛋白、上皮膜抗原、雌激素受体和神经内分泌标志物呈不同程度阳性。
将去分化子宫内膜样腺癌中的未分化癌误诊为3级子宫内膜样腺癌并不少见。认识这种新描述实体的形态学和免疫组化特征至关重要，因为它会改变治疗和预后。
