Deb Pratik Q, Marcus Jenna Z, Abedin Yasmin, Heller Debra S
Rutgers-New Jersey Medical School, Newark, NJ, USA.
Int J Surg Pathol. 2020 May;28(3):284-286. doi: 10.1177/1066896919886113. Epub 2019 Nov 5.
Endometrioid type of endometrial carcinoma is the most common form of uterine malignancy. The majority of patients in the developed world present with the low-grade, low-stage type of this malignancy. The current treatment of early-stage endometrioid carcinoma provides most patients with a favorable outcome. One of the important factors that determine the outcome of early-stage endometrial carcinoma is the involvement of cervical stroma. One of the very rare forms of cervical stromal involvement by endometrioid carcinoma is termed "adenoma malignum type" invasion due to its similarity to the infamously deceptive type of cervical adenocarcinoma called adenoma malignum. Since adenoma malignum is often discovered incidentally, finding adenoma malignum type of myoinvasion may deceive a pathologist to diagnose the simultaneous presence of endometrial carcinoma and adenoma malignum in the same patient as 2 separate entities. Also, this type of myoinvasion may be missed altogether for its subtle nature. In this article, we report a case of low-grade, low-stage endometrioid carcinoma with adenoma malignum type of myoinvasion. We have pointed out the subtle nature of this lesion and the important features to remember to successfully identify it.
子宫内膜样型子宫内膜癌是最常见的子宫恶性肿瘤形式。在发达国家，大多数此类恶性肿瘤患者表现为低级别、低分期类型。早期子宫内膜样癌的当前治疗为大多数患者带来了良好的预后。决定早期子宫内膜癌预后的重要因素之一是宫颈间质受累情况。子宫内膜样癌累及宫颈间质的极为罕见的形式之一被称为“恶性腺瘤型”浸润，因为它与臭名昭著的具有欺骗性的宫颈腺癌类型——恶性腺瘤相似。由于恶性腺瘤常常是偶然发现的，发现恶性腺瘤型肌层浸润可能会使病理学家误以为同一患者同时存在子宫内膜癌和恶性腺瘤这两个独立的实体。此外，这种类型的肌层浸润因其性质隐匿可能会完全被漏诊。在本文中，我们报告了一例伴有恶性腺瘤型肌层浸润的低级别、低分期子宫内膜样癌病例。我们指出了该病变的隐匿性质以及成功识别它需要牢记的重要特征。
