Limbachiya Dipak, Tiwari Rajnish, Kumari Rashmi, Trivedi Priti
Department of Gynaecological Endoscopy, Eva Women's Hospital, Neelkanth Park 2, Ghoda Camp Road, Shahibaug, Ahmedabad, 380004 India.
J Obstet Gynaecol India. 2025 Apr;75(Suppl 1):552-555. doi: 10.1007/s13224-024-02007-2. Epub 2024 Jul 10.
The DEAC, a rare entity, has an unfavorable clinical outcome. The role of adjuvant therapy is also controversial in this high-risk variety. The current FIGO grading may also lead to misdiagnosis of DEAC as FIGO grade 2 or 3 endometroid carcinoma, owing to histological insufficiency in assessing the details of solid component within a tumor. The recognition of UC component as a solid patternless growth is extremely important for a correct diagnosis of DEAC. Hereby, a 51-year-old female is presented with chief complaint of postmenopausal bleeding, with D&C report of a poorly differentiated carcinoma of endometrium. Complete comprehensive surgical staging was performed. The final HPE revealed 85-90% UC and 10-15% moderately differentiated endometroid carcinoma, which was finally IHC-proven as well. The disease was found metastatic to adnexa and retroperitoneal lymph nodes. Postoperatively patient was given chemotherapy as adjuvant therapy and she is asymptomatic on follow-up.
去分化子宫内膜腺癌(DEAC)是一种罕见的疾病,临床预后不佳。在这种高危类型中,辅助治疗的作用也存在争议。由于在评估肿瘤内实性成分细节方面组织学依据不足,目前的国际妇产科联盟(FIGO)分级也可能导致将DEAC误诊为FIGO 2级或3级子宫内膜样癌。将未分化癌(UC)成分识别为无模式的实性生长对于DEAC的正确诊断极为重要。在此,报告一名51岁女性,主要症状为绝经后出血,刮宫术报告为低分化子宫内膜癌。进行了完整的全面手术分期。最终的组织病理学检查显示85 - 90%为UC,10 - 15%为中分化子宫内膜样癌,最终免疫组化也得以证实。发现该疾病已转移至附件和腹膜后淋巴结。术后患者接受了化疗作为辅助治疗,随访时无症状。