Department of Surgical Pathology, Shaoxing Maternity and Child Health Care Hospital, East Street 305#, Shaoxing, Zhejiang Province, 312000, China.
Diagn Pathol. 2022 Oct 13;17(1):79. doi: 10.1186/s13000-022-01262-z.
Uterine somatic choriocarcinoma is a rare, clinically aggressive malignant tumor. They frequently concur with other cancer. However, the molecular pathogenesis between somatic choriocarcinoma and the concurrent carcinoma has rarely been addressed to date.
We report a 68-years old Chinese woman with a uterine choriocarcinoma arising from serous carcinoma. The patient underwent radical surgery including total abdominal hysterectomy with bilateral salpingo-oophorectomy, omentectomy and pelvic lymph node resection. She received 10 courses of post-operative chemotherapy. She died of disease 13 months after her surgery. Microscopically, the tumor showed a biphasic pattern of choriocarcinoma and serous carcinoma. The choriocarcinomatous component showed a combination of cytotrophoblast, intermediate trophoblast and syncytiotrophoblast with hemorrhage and necrosis. The component of serous carcinoma was characterized by solid sheets of small cells with marked nuclear atypia and occasional glandular and papillary formation. PD-L1 was exclusively expressed in the choriocarcinomatous component. Next-generation sequencing revealed that the genetic abnormalities were overlapping between the two components.
子宫体绒毛膜癌是一种罕见的、临床上侵袭性强的恶性肿瘤。它们常与其他癌症并存。然而，目前尚未对绒毛膜癌和并存的癌之间的分子发病机制进行研究。
我们报告了一例 68 岁的中国妇女，患有源自浆液性癌的子宫绒毛膜癌。患者接受了根治性手术，包括全腹部子宫切除术、双侧输卵管卵巢切除术、网膜切除术和盆腔淋巴结切除术。她接受了 10 个疗程的术后化疗。术后 13 个月，她死于疾病。显微镜下，肿瘤呈绒毛膜癌和浆液性癌的双相模式。绒毛膜癌成分表现为绒毛细胞、中间滋养细胞和合体滋养细胞的组合，伴有出血和坏死。浆液性癌的成分以小细胞的实性片为特征，具有明显的核异型性，偶尔有腺体和乳头状形成。PD-L1 仅在绒毛膜癌成分中表达。下一代测序显示两个成分之间存在重叠的遗传异常。
