Case 250 - Discussion

Uploaded: 2008-01-24, Updated: 2008-01-24

• Microscopic Description

  • Microscopically, the highly pleomorphic tumor cells are arranged in solid clusters or sheets with prominent geographic necrosis. Over 40% of the tumor cells are large with abundant clear cytoplasm and highly pleomorphic nuclei and prominent nucleoli. The are frequent giant tumor cells and abundant mitotic figures. In focal areas (approximately 20%) the tumor cells are large with abundant pale pink cytoplasm, round nuclei and prominent nucleoli. Focal well-differentiated endometrioid type carcinoma are noted that accounts for about 10% of the entire tumor.

  • By immunostainings, the well-differentiated endometrioid adenocarcinoma show significant loss of PTEN expression. The tumor cells are strongly diffusely and positive for ER but negative for PR. The P53 immunstaining reveals focal positivity in the solid areas of the tumor.

  • Along the left lateral site, the tumor invades into 2/3 of the entire thickness (1.5 cm) of myometrium. The deepest tumor is 0.5 cm from the serosa. The serosa, internal os, endocervical canal, bilateral fallopian tubes and bilateral ovaries are negative for tumor invasion.

• Diagnosis

  • Endometrial adenocarcinoma of uterus, predominantly clear cell type, high grade (FIGO III).