A case report of serous carcinoma of the uterine corpus
Journal
ULTRASOUND in Obstetrics & Gynecology
Date Issued
2022-09
Author(s)
Emil Bajalski
Bashkim Ismaili
Dimitar Georgiev
Aleksandar Nakov
Abstract
In the Republic of North Macedonia, in 2020, there were 369 new
cases of cancer of the uterine body, which were 10.9% of all new
cases of malignancies and was the third most common in women,
after breast cancer and colorectal cancer. Endometrial polyps are
common pathological findings and their prevalence is between
16% to 34%. The prevalence of malignant and premalignant
lesions found in the endometrial polyps ranges from 0.8% to
4.8%. Uterine serous carcinoma is an aggressive variant of EC that
accounts for only 5-10% of all EC, but is related with 80% of
endometrial cancer–related deaths. It is not related with increased
estrogen levels and atypical endometrial hyperplasia. They arise
in a background of atrophic endometrium or endometrial polyps
in postmenopausal women. We present a case of 72 years old
patient with serous carcinoma of the uterine corpus that arises
on endometrial polyp. She was 20 years postmenopausal and
bleeding was present. The transvaginal ultrasound examination
showed that heterogeneous and irregular endometrial thickening
was present. We performed fractionated explorative curettage.
The histopathological report showed the presence of the parts of
an endometrial polyp with surface that is coated with atrophic
endometrium, and in parts it was coated with malignantly altered
endometrium. The morphology of serous endometrial carcinoma
with complex papillary and glandular architecture was present.
Pathological mitoses have been verified. Lymphovascular invasion or
infiltration of the cervical stroma were not found. Total abdominal
hysterectomy with bilateral salpingo-oophorectomy was performed.
Histopathological analysis of the operative material showed the
absence of lymphovascular infiltration but present infiltration of the
cervical stroma (pTNM= pT2 pNx pMx R0 L0 V0 Stage II). The
patient was referred for further treatment to an oncologist.
cases of cancer of the uterine body, which were 10.9% of all new
cases of malignancies and was the third most common in women,
after breast cancer and colorectal cancer. Endometrial polyps are
common pathological findings and their prevalence is between
16% to 34%. The prevalence of malignant and premalignant
lesions found in the endometrial polyps ranges from 0.8% to
4.8%. Uterine serous carcinoma is an aggressive variant of EC that
accounts for only 5-10% of all EC, but is related with 80% of
endometrial cancer–related deaths. It is not related with increased
estrogen levels and atypical endometrial hyperplasia. They arise
in a background of atrophic endometrium or endometrial polyps
in postmenopausal women. We present a case of 72 years old
patient with serous carcinoma of the uterine corpus that arises
on endometrial polyp. She was 20 years postmenopausal and
bleeding was present. The transvaginal ultrasound examination
showed that heterogeneous and irregular endometrial thickening
was present. We performed fractionated explorative curettage.
The histopathological report showed the presence of the parts of
an endometrial polyp with surface that is coated with atrophic
endometrium, and in parts it was coated with malignantly altered
endometrium. The morphology of serous endometrial carcinoma
with complex papillary and glandular architecture was present.
Pathological mitoses have been verified. Lymphovascular invasion or
infiltration of the cervical stroma were not found. Total abdominal
hysterectomy with bilateral salpingo-oophorectomy was performed.
Histopathological analysis of the operative material showed the
absence of lymphovascular infiltration but present infiltration of the
cervical stroma (pTNM= pT2 pNx pMx R0 L0 V0 Stage II). The
patient was referred for further treatment to an oncologist.
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