scholarly journals Endometrioid Adenocarcinoma Arising in Adenomyoma in a Woman with a Genital Prolapse - Case Report

2018 ◽  
Vol 6 (6) ◽  
pp. 1091-1094 ◽  
Author(s):  
Vesna S. Antovska ◽  
Iskra Krstevska ◽  
Milka Trajanova ◽  
Jasmina Chelebieva ◽  
Irena Gosheva ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Clinical Symptoms ◽  
Endometrial Adenocarcinoma ◽  
Uterine Cavity ◽  
Genital Prolapse ◽  
Uterine Wall ◽  
Low Grade ◽  
Endometrioid Adenocarcinoma ◽  
Ultrasound Evaluation ◽  
Well Differentiated

BACKGROUND: Endometrial cancer is the third-ranked genital malignancy in women and includes 3% of cancer deaths. There is a 2.8% chance of a woman developing endometrial cancer during her lifetime. Low-grade endometrioid adenocarcinomas are often seen along with endometrial hyperplasia, but high-grade endometrioid adenocarcinomas have more solid sheets of less-differentiated tumour cells, which are no longer organised into glands, often associated with surrounded atrophic endometrium.CASE REPORT: We present an unusual case of endometrial adenocarcinoma arising in adenomyoma in 74-year old woman presented with genital prolapse, without other clinical symptoms. Ultrasound evaluation revealed endometrium with 4 mm-thickness and atrophic ovaries. The cervical smear was normal. The patient underwent a total vaginal hysterectomy. The histopathology of the anterior uterine wall revealed an intramural adenomyoma of 4 mm in which some endometrial glands with malignant transformation of well-differentiated endometrioid adenocarcinoma without infiltration in surrounding myometrium and lymphovascular invasion were present. The endometrium lining the uterine cavity was predominantly atrophic, and only one focus of simplex and complex hyperplasia was found, with cell-atypia. According to AJCC/FIGO 2010, the tumour was classified: pTNM = pT1B pNX pMX G1 R0 L0 V0 NG1, Stage I. On dismiss, the near-future oncological consultation was recommended.CONCLUSION: We would like to point out the rare occurrence of such type of malignancy and the importance of meticulous histopathology evaluation, even after reconstructive surgery for genital prolapse.

Can the apparent diffusion coefficient differentiate the grade of endometrioid adenocarcinoma and the histological subtype of endometrial cancer?

2017 ◽  
Vol 59 (3) ◽  
pp. 363-370 ◽  
Author(s):  
Bin Yan ◽  
Tingting Zhao ◽  
Xiufen Liang ◽  
Chen Niu ◽  
Caixia Ding
Keyword(s):  
Diffusion Coefficient ◽  
Endometrial Cancer ◽  
Apparent Diffusion Coefficient ◽  
Low Grade ◽  
Endometrioid Adenocarcinoma ◽  
High Grade ◽  
Squamous Differentiation ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Endometrial Cancers

Background Diffusion-weighted imaging (DWI) provides useful information for the identification of benign and malignant uterine lesions. However, the use of the apparent diffusion coefficient (ADC) for histopathological grading of endometrial cancer is controversial. Purpose To explore the use of ADC values in differentiating the preoperative tumor grading of endometrioid adenocarcinomas and investigate the relationship between the ADC values of endometrial cancer and the histological tumor subtype. Material and Methods We retrospectively evaluated 98 patients with endometrial cancers, including both endometrioid adenocarcinomas (n = 80) and non-endometrioid adenocarcinomas (n = 18). All patients underwent DWI procedures and ADC values were calculated. The Kruskal–Wallis test and the independent samples Mann–Whitney U test were used to compare differences in the ADC values between different tumor grades and different histological subtypes. Results The mean ADC values (ADCmean) for high-grade endometrioid adenocarcinomas were significantly lower than the values for low-grade tumors (0.800 versus 0.962 × 10–3 mm2/s) ( P = 0.002). However, no significant differences in ADCmean and minimum ADC values (ADCmin) were found between tumor grades (G1, G2, and G3) of endometrial cancer. Compared with endometrioid adenocarcinomas, the adenocarcinoma with squamous differentiation showed lower ADC values (mean/minimum = 0.863/0.636 versus 0.962/0.689 × 10–3 mm2/s), but the differences were not significant ( Pmean = 0.074, Pmin = 0.441). Moreover, ADCmean for carcinosarcomas was significantly higher than the value for G3 non-carcinosarcoma endometrial cancers (1.047 versus 0.823 × 10–3 mm2/s) ( P = 0.001). Conclusion The ADCmean was useful for identifying high-grade and low-grade endometrioid adenocarcinomas. Additionally, squamous differentiation may decrease ADCmean and ADCmin of endometrioid adenocarcinoma, and carcinosarcomas showed relatively high ADCmean.

Distant recurrence of endometrial cancer more than 10 years after hysterectomy: a case report

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Boom Ping Khoo ◽  
Kah Teik Chew ◽  
Erica Yee Hing ◽  
Nirmala Kampan ◽  
Mohamad Nasir Shafiee
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Adenocarcinoma ◽  
Late Recurrence ◽  
Distant Recurrence ◽  
Low Grade ◽  
Case Presentation ◽  
Primary Surgery ◽  
Review Analysis ◽  
Stage 1 ◽  
Cell Dormancy

Abstract Objectives Endometrial cancer is the sixth most common cancer among women and recurrence of after 10 years is extremely rare. Case presentation We reported a comprehensive review of histopathology, investigations and treatment regarding a woman with distant recurrence of endometrial cancer to rectus abdominis muscle after 23 years from the primary surgery. Previous published literatures of similar case were included into the review analysis. A total of 11 similar cases had been reported. Overall, 9 (81.8%) cases were stage 1 disease and only 2 cases were classified as stage II disease. The majority, 6 (54.5%) cases were endometrial adenocarcinoma. Majority of the cases shared the similarity of low grade endometrial cancer with positive oestrogen receptor immunophynetype. Conclusions Thus, the phenomenon of ‘cell dormancy’ was hypothesized to explain the mechanism of late recurrence for these cases.

scholarly journals Fertility-sparing treatment in women with endometrial cancer

2020 ◽  
Vol 47 (4) ◽  
pp. 237-244
Author(s):  
Seyeon Won ◽  
Mi Kyoung Kim ◽  
Seok Ju Seong
Keyword(s):  
Endometrial Cancer ◽  
Young Women ◽  
Eligible Patient ◽  
Myometrial Invasion ◽  
Definitive Treatment ◽  
High Dose ◽  
Low Grade ◽  
Endometrioid Adenocarcinoma ◽  
Fertility Sparing ◽  
The Ideal

Endometrial cancer (EC) in young women tends to be early-stage and low-grade; therefore, such cases have good prognoses. Fertility-sparing treatment with progestin is a potential alternative to definitive treatment (i.e., total hysterectomy, bilateral salpingo-oophorectomy, pelvic washing, and/or lymphadenectomy) for selected patients. However, no evidence-based consensus or guidelines yet exist, and this topic is subject to much debate. Generally, the ideal candidates for fertility-sparing treatment have been suggested to be young women with grade 1 endometrioid adenocarcinoma confined to the endometrium. Magnetic resonance imaging should be performed to rule out myometrial invasion and extrauterine disease before initiating fertility-sparing treatment. Although various fertility-sparing treatment methods exist, including the levonorgestrel-intrauterine system, metformin, gonadotropin-releasing hormone agonists, photodynamic therapy, and hysteroscopic resection, the most common method is high-dose oral progestin (medroxyprogesterone acetate at 500–600 mg daily or megestrol acetate at 160 mg daily). During treatment, re-evaluation of the endometrium with dilation and curettage at 3 months is recommended. Although no consensus exists regarding the ideal duration of maintenance treatment after achieving regression, it is reasonable to consider maintaining the progestin therapy until pregnancy with individualization. According to the literature, the ovarian stimulation drugs used for fertility treatments appear safe. Hysterectomy should be performed after childbearing, and hysterectomy without oophorectomy can also be considered for young women. The available evidence suggests that fertility-sparing treatment is effective and does not appear to worsen the prognosis. If an eligible patient strongly desires fertility despite the risk of recurrence, the clinician should consider fertility-sparing treatment with close follow-up.

Diagnostic clinical application of two-color fluorescence in situ hybridization that detects chromosome 1 and 17 alterations to direct touch smear and liquid-based thin-layer cytologic preparations of endometrial cancers

2005 ◽  
Vol 15 (1) ◽  
pp. 70-80
Author(s):  
N. Susumu ◽  
D. Aoki ◽  
T. Noda ◽  
Y. Nagashima ◽  
T. Hirao ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Thin Layer ◽  
Endometrial Adenocarcinoma ◽  
Premalignant Lesions ◽  
Chromosome 1 ◽  
Fish Analysis ◽  
Endometrioid Adenocarcinoma ◽  
Structural Abnormalities ◽  
Endometrial Cancers

We performed two-color fluorescence in situ hybridization (FISH) on direct touch smears and liquid-based thin-layer (ThinPrep) cytological preparations of endometrial tumors to detect alterations of chromosome 1 and 17 that present with high incidence in endometrial cancers. The DNA probes used for two-color FISH analysis were a combination of the probes designed for 17cen (cCI 17-321) and 17p13.3 (D17S34), and a combination of the probes designed for 1q12 (D1Z1) and 1p36 (cCI1-5335). Numerical or structural alterations of chromosome 1 and/or 17 were detected in 95% (19 of 20 cases) of the direct touch smears obtained from endometrial cancer, while these alterations were also detected in 93% (12 of 13 cases) of samples obtained from grade 1 endometrioid adenocarcinoma cases, including three cases that could not be diagnosed as positive by conventional Papanicolaou cytopathologic staining. Using ThinPrep cytopathologic preparations, numerical or structural abnormalities were found in 26 (90%) and five (100%) cases, respectively, of samples obtained transcervically from 29 endometrial cancer and five atypical endometrial hyperplasia cases. Therefore, two-color FISH may be a useful diagnostic method for endometrial adenocarcinoma and premalignant lesions that demonstrate only slight cellular atypia in conventional cytopathologic preparations.

scholarly journals Anti-Müllerian Hormone Expression in Endometrial Cancer Tissue

2019 ◽  
Vol 20 (6) ◽  
pp. 1325 ◽  
Author(s):  
Marek Gowkielewicz ◽  
Aleksandra Lipka ◽  
Aleksandra Piotrowska ◽  
Marta Szadurska-Noga ◽  
Jacek Nowakowski ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Tissue Microarrays ◽  
Cancer Tissue ◽  
Endometrioid Adenocarcinoma ◽  
Mullerian Ducts ◽  
Immunohistochemical Assessment ◽  
Prognosis Marker ◽  
Well Differentiated

Anti-Müllerian hormone (AMH) is a commonly known factor secreted by Sertoli cells, responsible for regression of the Müllerian ducts in male fetuses. AMH has also other functions in humans. In vivo and in vitro studies have shown that AMH inhibits cell cycle and induces apoptosis in cancers with AMH receptors. The aim of the study was to assess whether the tissue of pre-cancerous states of endometrium (PCS) and various histopathologic types of endometrial cancer (EC) exhibit the presence of AMH. We aimed to investigate whether the potential presence of the protein concerns menopausal women or those regularly menstruating, and whether is related to cancers with a good or a bad prognosis, as well as what other factors may influence AMH expression. The undertaken analysis was carried out on tissues retrieved from 232 women who underwent surgical treatment for PCS and EC. Tissues were prepared for immunohistochemical assessment with the use of a tissue microarrays method. AMH expression was confirmed in 23 patients with well differentiated endometrioid adenocarcinoma (G1), moderately differentiated endometrioid adenocarcinoma (G2), clear cell carcinoma (CCA) and nonatypical hyperplasia. AMH was not found in EC tissues in regularly menstruating women. An appropriately long mean period of breastfeeding in line with a prolonged period of hormonal activity had a positive effect on AMH expression. Our results may suggest that AMH is a factor which protects the organism against cancer, and should be further investigated as a potential prognosis marker and a therapeutic agent.

scholarly journals Abdominal skin metastasis in endometrial cancer

2019 ◽  
Vol 27 (2) ◽  
pp. 84
Author(s):  
Eccita Rahestyningtyas ◽  
Pungky Mulawardhana ◽  
Tomy Lesmana
Keyword(s):  
Endometrial Cancer ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Low Grade ◽  
Endometrioid Adenocarcinoma ◽  
Comprehensive Management ◽  
High Risk Factors ◽  
History Of ◽  
Anatomical Pathology

Objectives: Surgical wound metastases in stage 1 endometrial cancer are possible, with a variety of different pathophysiological possibilities. Comprehensive management is needed to keep the patient on the possibility of a good prognosis.Cases Report: During January 2015 – January 2018 at dr. Soetomo Hospital, there were 2 cases of metastatic endometrial cancer in the laparotomy wounds by which the condition is very rare. Case 1, The patient was diagnosed with endometrial carcinoma following the results of curettage. Anatomical pathology examination was done and obtained grade 2 endometrioid adenocarcinoma. In Case 2, the patient underwent Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy in 2013 at Mojokerto General Hospital, indicating Uterine Fibroids and Ovarian Cysts. The results of anatomical pathology examination were unknown. On April 2017, the patient complained abdominal swelling since 3 months ago.Conclusion: In January 2015 - January 2018, 2 cases of metastatic endometrial cancer was found in a former laparotomy operation where this condition is very rare in endometrial cancer cases with low grade ,so that follow-up, monitoring and more vigilance are required in patients with low-grade endometrial Ca who have finished undergoing a surgery and chemotherapy. Rapture or mass resection, followed by external radiation, may be performed in patients with recurrence in the laparotomy wound area or in patients with high risk factors for endometrial cancer such as a history of estrogen use, tamoxifen, nullipara, obesity, diabetes mellitus, and family history of endometrial cancer. Currently, there is no fixed procedure (guideline) in RS. Dr. Soetomo to overcome recurrences especially in the scars of cancer surgery.

scholarly journals Application value of contrast-enhanced ultrasound in the diagnosis of intermediate trophoblastic tumours

2021 ◽  
Author(s):  
XiaoDan Zhu ◽  
Yin Hu ◽  
Linyu Zhou ◽  
Tian'an Jiang
Keyword(s):  
Vaginal Bleeding ◽  
Clinical Symptoms ◽  
Correct Diagnosis ◽  
Uterine Cavity ◽  
Arterial Phase ◽  
Low Grade ◽  
Ultrasound Images ◽  
Type I ◽  
Contrast Enhanced ◽  
Trophoblastic Tumours

Abstract Background Through the research and analysis of colour Doppler ultrasound images (CDFIs) and contrast-enhanced ultrasonography (CEUS) images of intermediate trophoblastic tumours (ITTs), the ultrasound characteristics and CEUS perfusion characteristics are summarized, and these findings can provide a reference for the correct diagnosis of ITTs. Methods Seven ITT patients were diagnosed and treated in our institution from January 2016 to August 2020, and their clinical characteristics and ultrasound image characteristics were studied. Results The most common clinical symptoms of an ITT are vaginal bleeding and menopause. In the study, 6 patients had a history of menopause, 5 patients had irregular vaginal bleeding, and 1 patient was asymptomatic. The serum ß-human chorionic gonadotropin (ß-hCG) level was mainly a low-grade increase, and the average level was approximately 8167 IU/L. However, the ß-hCG level in one patient with lung metastasis was not high (53.2 IU/L), and the ß-hCG level in the other patient with ovarian and bladder metastases was high (55422.2 IU/L). In grey-scale ultrasound, ITTs can be divided into 3 types: type I, where most of the lesions protrude into the uterine cavity (2 patients); type II, where the lesions are partly located in the uterine cavity and partly in the muscle layer (3 patients); and type III, where the lesions are limited to the myometrium (2 patients). The internal echo of the lesion can be divided into solid and cystic-solid echo. CDFI shows that blood flow signals from minimal to abundant. The enhancement mode of CEUS is mainly regional enhancement (5 patients), the arterial phase is mainly slow and equal-slightly high enhancement (6 patients), and the enhancement boundary is not clear (6 patients). Conclusions Certain characteristic changes in CEUS of ITTs, combined with clinical features, can provide help for the accurate diagnosis of ITT.

Prolonged Conservative Treatment of Endometrial Cancer Patients: More Than 1 Pregnancy Can Be Achieved

2011 ◽  
Vol 21 (1) ◽  
pp. 72-78 ◽  
Author(s):  
Tamar Perri ◽  
Jacob Korach ◽  
Walter H. Gotlieb ◽  
Mario Beiner ◽  
Dror Meirow ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Conservative Treatment ◽  
Early Stage ◽  
Intrauterine Device ◽  
Endometrial Adenocarcinoma ◽  
Tertiary Care ◽  
Young Patients ◽  
High Recurrence Rate ◽  
High Dose ◽  
Endometrioid Adenocarcinoma

Background:Preserving reproductive function in young patients with early endometrial cancer is an accepted concept today. The safety and feasibility of long-term conservative treatment, allowing more than 1 pregnancy, remain to be ascertained.Methods:This study was a retrospective chart review of a 27 women with endometrioid adenocarcinoma of the endometrium, who were treated conservatively at 2 tertiary-care institutions. Treatment comprised oral high-dose progestins with or without a levonorgestrel-releasing intrauterine device. Endometrial biopsy was repeated every 2 to 3 months.Results:Over 7.8 to 412 months (median, 57.4 months), tumors regressed completely in 24 (89%) of 27 patients and partially in 2 patients, with 79% responding within 1 to 17 months. Of the complete responders, 15 (62%) of 24 had a recurrence; 4 underwent hysterectomy, and 11 underwent subsequent progestational treatment. All 11 responded, and 3 subsequently conceived. After 2 to 4 years, 5 patients again had a recurrence, of whom 3 underwent hysterectomy. Overall, 2 patients developed ovarian adenocarcinoma. All patients are currently disease-free. Conception occurred in 14 (51.8%) of 27 patients, in 5 more than once. There were 17 live births, and 2 patients are pregnant.Conclusions:According to our data, prolonged progestational therapy for early-stage endometrial adenocarcinoma, allowing women to conceive, is feasible and apparently does not alter clinical outcome. Patients should be advised of the high recurrence rate and possible concomitant ovarian malignancy.

scholarly journals Mesonephric-Like Adenocarcinoma of the Endometrium: Diagnostic Advances to Spot This Wolf in Sheep’s Clothing. A Review of the Literature

2021 ◽  
Vol 10 (4) ◽  
pp. 698
Author(s):  
Ellen Deolet ◽  
Jo Van Dorpe ◽  
Koen Van de Vijver
Keyword(s):  
Current Knowledge ◽  
Endometrial Adenocarcinoma ◽  
Growth Patterns ◽  
Serous Carcinoma ◽  
Low Grade ◽  
Endometrioid Adenocarcinoma ◽  
Comprehensive Overview ◽  
Uterine Corpus ◽  
Mesonephric Adenocarcinoma ◽  
Early Local Recurrence

Mesonephric-like adenocarcinoma is a recently described rare neoplasm occurring in the uterine corpus and ovary. This under-recognized subtype of carcinoma can be very challenging to diagnose. In mesonephric adenocarcinoma a variety of growth patterns can be present within the same tumor, as a result of which they can be misinterpreted and diagnosed as low-grade endometrioid adenocarcinoma, clear cell carcinoma, or even serous carcinoma and carcinosarcoma. We report a case of mesonephric-like adenocarcinoma misdiagnosed as a low-grade endometrioid endometrial adenocarcinoma that had an early local recurrence and metastasized to the liver and the lungs. Histopathological, immunohistochemical and molecular analysis were performed and compared to published literature, providing a comprehensive overview of the current knowledge. Databases (Pubmed, Web of Science, Google Scholar) were searched with a combination of the following search terms: mesonephric-like, mesonephric, adenocarcinoma, carcinoma, uterine body, uterine corpus, endometrium. Mesonephric-like adenocarcinoma is a difficult-to-diagnose entity. Advanced diagnostics, including improved morphologic, immunohistochemical and molecular knowledge can help develop new therapeutic strategies against this specific subtype of endometrial cancer with an aggressive clinical behavior.

scholarly journals Endometrial Carcinoma in a 26-Year-Old Patient with Bardet-Biedl Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Olga Grechukhina ◽  
Gregory M. Gressel ◽  
William Munday ◽  
Serena Wong ◽  
Alessandro Santin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Endometrial Adenocarcinoma ◽  
Clinical Signs ◽  
Young Patients ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrioid Adenocarcinoma ◽  
Bardet Biedl Syndrome ◽  
Obesity And Diabetes

Background. Bardet-Biedl Syndrome (BBS) is a rare genetic condition characterized by cognitive impairment, dysmorphism, central obesity, and diabetes mellitus, among other abnormalities. Although some of these characteristics are known independent risk factors for endometrial cancer and its precursors, the association between BBS and endometrial cancer is underreported. Case. We present the case of a 26-year-old patient with BBS and clinical signs of hyperestrogenism who presented with abnormal uterine bleeding and was diagnosed with endometrioid adenocarcinoma. She ultimately underwent definitive surgical treatment with hysterectomy and bilateral salpingectomy. Conclusions. This is one of only a few reports in the literature describing the association of BBS and endometrioid endometrial adenocarcinoma. Given the association of BBS with risk factors for hyperestrogenism such as truncal obesity, hyperinsulinemia, and ovulatory dysfunction, providers should have increased suspicion for endometrial cancer in young patients with BBS and abnormal uterine bleeding.

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