Papillary adenocarcinoma in the endometrium.

Papillary adenocarcinoma should be regarded as a subtype of endometrial carcinoma with poor prognosis. Review of 22 cases indicates an older average age than is found with the usual endometrioid type, with frequent surgical upstaging, deep myometrial invasion, nodal and adnexal involvement, positive peritoneal washings, upper abdominal recurrence, and poor response to conventional treatment. These observations suggest a different natural history from that of the more common histologic subtypes of endometrial carcinoma. Management should include initial exploration of the entire abdominal cavity to determine the true extent of the disease, and treatment must include the upper abdomen.