scholarly journals Carcinoma of the Lower Uterine Segment: A Newly Described Association With Lynch Syndrome

2008 ◽  
Vol 26 (36) ◽  
pp. 5965-5971 ◽  
Author(s):  
Shannon N. Westin ◽  
Robin A. Lacour ◽  
Diana L. Urbauer ◽  
Rajyalakshmi Luthra ◽  
Diane C. Bodurka ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lynch Syndrome ◽  
Endometrial Carcinoma ◽  
Lower Uterine Segment ◽  
Endometrioid Adenocarcinoma ◽  
Clinicopathologic Characteristics ◽  
Endocervical Adenocarcinoma ◽  
Case Comparison ◽  
Pathology Reports ◽  
Clinical Records

Purpose Endometrial carcinoma in the lower uterine segment (LUS) is a poorly described cancer that can be clinically confused with endocervical carcinoma. We performed a case-comparison study to document the clinicopathologic characteristics of LUS tumors and their association with risk factors for endometrial cancer. Patients and Methods The clinical records and pathology reports from women who underwent hysterectomy at our institution for endometrial or endocervical adenocarcinoma over an 11-year interval were reviewed. The LUS group consisted of women with endometrial tumors that clearly originated between the lower uterine corpus and the upper endocervix. Immunohistochemistry and microsatellite instability and MLH1 methylation assays were performed. Results Thirty-five (3.5%) of 1,009 women had endometrial carcinoma of the LUS. Compared with patients with corpus tumors, LUS patients were younger, had higher stage tumors, and had more invasive tumors. Preoperative diagnosis of the LUS tumors more frequently included the possibility of endocervical adenocarcinoma. Seventy-three percent of the LUS tumors had an immunohistochemical expression pattern typical of conventional endometrioid adenocarcinoma. Ten (29%) of 35 women with LUS tumors were confirmed to have Lynch syndrome or were strongly suspected to have Lynch syndrome on the basis of tissue-based molecular assays. Conclusion The prevalence of Lynch syndrome in patients with LUS endometrial carcinoma (29%) is much greater than that of the general endometrial cancer patient population (1.8%) or in endometrial cancer patients younger than age 50 years (8% to 9%). On the basis of our results, the possibility of Lynch syndrome should be considered in women with LUS tumors.

Clinicopathologic characteristics of endometrial cancer in Lynch syndrome.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5098-5098
Author(s):  
Fabrice Lecuru ◽  
Julie Bouquier ◽  
marie-Aude le Frere-Belda ◽  
Cherazade Bensaid ◽  
Claude Nos ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lynch Syndrome ◽  
Age At Onset ◽  
Lower Uterine Segment ◽  
High Rate ◽  
Serous Carcinoma ◽  
Endometrioid Adenocarcinoma ◽  
Clinicopathologic Characteristics ◽  
Stage Ib

5098 Background: Poor data exist on clinico-pathological description of endometrial cancer (EC) in Lynch syndrome (LS) compared with sporadic ones. To evaluate the clinico-pathological findings of Lynch-related EC to establish histological criteria to discriminate familial and sporadic EC and to decide the optimal management of patients. Methods: Retrospective study of prospective cohort of patients with LS in our institution from 1999 to 2011. We identified and described all cases of endometrial cancers. Management and follow-up were detailed. Results: Of a cohort of 126 patients with LS, 10 women developed endometrial carcinoma. The median age at diagnosis was 51 years (41-58). Five patients had an identified mutation (2 hMLH1, 2 hMSH2 and 1 hMSH6). In 9 cases, EC was the first Lynch-related tumor to occur. No patient developed ovarian cancer. All, except 2 patients (1 serous carcinoma and 1 clear cell carcinoma), had endometrioid adenocarcinoma (80%). Tumor grade was grade 1 in 3 patients, grade 2 in 5 and grade 3 in 2 patients. Forty per cent of patients had lymphovascular space involvement (LVSI). The FIGO stages were as follows: stage IA (n=7), stage IB (n=2) and stage IIIC (n=1). Four in ten patients had tumor located in the lower uterine segment. With a median follow-up of 14 months (range 9 – 40 months), recurrence occurred in one patient with a stage IB grade 2 endometrioid adenocarcinoma with LVSI. Conclusions: EC in LS is characterized by early age at onset, localization in lower uterine segment, and high rate of LVSI. Other data on histology and survival do not differ from sporadic cancers. These results suggest that we can consider conservative treatment in patients with good prognosis tumors. Further studies are required.

scholarly journals A novel germline mutation in hMLH1 in three Korean women with endometrial cancer in a family of Lynch syndrome: case report and literature review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Youn-Joon Jung ◽  
Hye Ryoun Kim ◽  
Mi Kyung Kim ◽  
Eun-Ju Lee
Keyword(s):  
Endometrial Cancer ◽  
Case Report ◽  
Lynch Syndrome ◽  
Immunohistochemical Analysis ◽  
Endometrioid Adenocarcinoma ◽  
Korean Women ◽  
Uterine Carcinosarcoma ◽  
Case Presentation ◽  
Endometrioid Endometrial Cancer ◽  
Paraaortic Lymph Node Dissection

Abstract Background Endometrial cancer is often the sentinel cancer in women with Lynch syndrome, among which endometrioid endometrial cancer is the most common. We found a Korean case of uterine carcinosarcoma associated with Lynch syndrome. And we reviewed 27 Korean women with endometrial cancer associated with Lynch syndrome already released in case report so far. Case presentation The proband, a 45-year-old Korean woman received treatment for endometrioid adenocarcinoma. Her older sister and niece were treated for endometrioid adenocarcinoma and carcinosarcoma, respectively. Family history met the Amsterdam II criteria and immunohistochemical analysis revealed a loss of MLH1 and PMS2. They all harbored a previously unreported germline likely pathogenic variant in c.1367delC in MLH1. They underwent staging operations including total hysterectomy, bilateral salpingo-oophorectomy, pelvic/paraaortic lymph node dissection, and washing cytology. All three women were healthy without evidence of relapse for over 4 years. Conclusion This report indicates a novel germline c.1367delC variant in MLH1, and presents a Korean case of uterine carcinosarcoma associated with Lynch syndrome. Furthermore, the c.1757_1758insC variant in MLH1 was suggested as a founder mutation in Lynch syndrome in Korean women.

Clinicopathologic characteristics of endometrial carcinoma metastatic to the ovary compared to endometrial carcinoma with synchronous ovarian carcinoma.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17105-e17105
Author(s):  
Natalia Rodriguez Gomez Hidalgo ◽  
Robert A. Soslow ◽  
Britta Weigelt ◽  
Vasileios Sioulas ◽  
Alessia Aloisi ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Statistical Tests ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Ovarian Carcinomas ◽  
Clinicopathologic Characteristics ◽  
Entire Cohort ◽  
Primary Surgery ◽  
Pathology Reports

e17105 Background: According to recent reports, sporadic synchronous endometrial and ovarian cancers (SEOCs) of endometrioid histology may be clonally related. We sought to characterize the clinicopathologic characteristics and outcomes of patients with SEOC compared to those with endometrial carcinoma felt to have metastasis to the ovaries. Methods: All patients with endometrial cancer who underwent primary surgery at our institution from 06/1993- 09/2014 were identified. We included cases with carcinoma in the endometrium and ovary. Pathology reports were reviewed to determine the pathologist’s assessment of whether the ovarian carcinomas were likely synchronous or metastatic. Patients with stage IV endometrial carcinoma, irrespective of presence of ovarian disease, were excluded. Appropriate statistical tests were performed. Results: We identified 76 eligible cases; 19 were deemed SEOCs and 57 endometrial carcinoma with ovarian metastasis (ECOM). Median age was 52 years (range, 32-71) and 63 years (range, 43-89), respectively (p = 0.4). Non-endometrioid histology was observed in 21% of SEOCs compared with 58% of ECOMs (p = 0.006). There was no myoinvasion in 32% of SEOCs compared with 9% of ECOMs (p = 0.01). Endometriosis was noted in 58% of SEOCs compared with 4% of ECOMs (p < 0.0001). The median follow-up time was 44.2 months (range, 0.4-201.4) for the entire cohort. The 4-year progression-free survival (PFS) rates were 82% (SE+/-9.5) for SEOCs and 51.6% (SE+/- 7) for ECOMs (p = 0.06). The 4-year overall survival (OS) rates were 94.7% (SE+/-5.1) for SEOCs and 69.8% (SE+/-6.2) for ECOMs (p = 0.046). The 4-year PFS rates for cases of endometrioid histology alone were 84% (SE+/-10.6) for SEOCs and 77.8% (SE+/-8.87) for ECOMs (p = 0.97). The 4-year OS rates for cases of endometrioid histology alone were 93.3% (SE+/-8.4) and 81.9% (SE+/-8.2), respectively (p = 0.3). Conclusions: SEOC was associated with more favorable endometrial factors and with the presence of endometriosis, consistent with the notion that these are likely dissemination by retrograde flux. SEOC was associated with better survival outcomes but not when analyzing endometrioid histology alone.

Bone Metastasis in Primary Endometrial Carcinoma: Features, Outcomes, and Predictors

2014 ◽  
Vol 24 (1) ◽  
pp. 107-112 ◽  
Author(s):  
Aera Yoon ◽  
Chel Hun Choi ◽  
Tae-Hyun Kim ◽  
June-Kuk Choi ◽  
Jin-Young Park ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Bone Metastasis ◽  
Confidence Interval ◽  
Endometrial Carcinoma ◽  
Bone Lesion ◽  
Hazard Ratio ◽  
Clinicopathologic Characteristics ◽  
Entire Cohort ◽  
Stage Disease ◽  
Diagnosis Of Bone Metastasis

ObjectivesThis study aimed to describe the clinicopathologic characteristics and outcomes and to assess the predictors associated with prognosis in endometrial carcinoma that developed bone metastasis.MethodsA retrospective review of medical records was performed to identify the patients with endometrial carcinoma who developed bone metastasis between October 1994 and May 2012.ResultsOf the 1185 patients with endometrial carcinoma, 22 (1.8%) were identified with bone metastasis, and 21 patients were analyzed in the study. Seventeen (80.9%) patients had advanced-stage disease (2009 International Federation of Gynecologists and Obstetricians stages III-IV). Four (19.0%) patients had a bone lesion at the diagnosis of endometrial cancer. The median time of recurrence to the bone in 17 patients was 9 months (range, 2–43 months). The median overall survival (OS) and survival after bone metastasis of the entire cohort were 33 months (range, 9–57 months) and 15 months (range, 12–17 months), respectively. The patients with bone metastasis at recurrence had significantly longer OS than those patients with bone metastasis at diagnosis of endometrial cancer (36 vs 13 months; P = 0.042). Metastasis to extrapelvic bone was significantly associated with longer OS (46 vs 19 months; P = 0.001) and longer survival after bone metastasis (25 vs 12 months; P = 0.002). Isolated bone recurrence without extraosseous metastases and extrapelvic bone metastasis revealed independent predictors for survival after bone metastasis (hazard ratio, 0.09; 95% confidence interval, 0.01–0.67; P = 0.019 and hazard ratio, 0.07; 95% confidence interval, 0.01–0.53; P = 0.01).ConclusionsIn endometrial carcinoma that develops bone metastasis, isolated bone recurrence and extrapelvic bone metastasis are significant predictors of prolonged survival after the diagnosis of bone metastasis. Further researches on the optimal treatment modality and factors that have the clinical implications are warranted.

scholarly journals Generating high-quality data abstractions from scanned clinical records: text-mining-assisted extraction of endometrial carcinoma pathology features as proof of principle

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e037740
Author(s):  
Anthony Nguyen ◽  
John O'Dwyer ◽  
Thanh Vu ◽  
Penelope M Webb ◽  
Sharon E Johnatty ◽  
...  
Keyword(s):  
Text Mining ◽  
Medical Research ◽  
Endometrial Carcinoma ◽  
Expert Knowledge ◽  
Quality Data ◽  
High Quality ◽  
High Quality Data ◽  
Pathology Reports ◽  
Clinical Records ◽  
Research Studies

ObjectiveMedical research studies often rely on the manual collection of data from scanned typewritten clinical records, which can be laborious, time consuming and error prone because of the need to review individual clinical records. We aimed to use text mining to assist with the extraction of clinical features from complex text-based scanned pathology records for medical research studies.DesignText mining performance was measured by extracting and annotating three distinct pathological features from scanned photocopies of endometrial carcinoma clinical pathology reports, and comparing results to manually abstracted terms. Inclusion and exclusion keyword trigger terms to capture leiomyomas, endometriosis and adenomyosis were provided based on expert knowledge. Terms were expanded with character variations based on common optical character recognition (OCR) error patterns as well as negation phrases found in sample reports. The approach was evaluated on an unseen test set of 1293 scanned pathology reports originating from laboratories across Australia.SettingScanned typewritten pathology reports for women aged 18–79 years with newly diagnosed endometrial cancer (2005–2007) in Australia.ResultsHigh concordance with final abstracted codes was observed for identifying the presence of three pathology features (94%–98% F-measure). The approach was more consistent and reliable than manual abstractions, identifying 3%–14% additional feature instances.ConclusionKeyword trigger-based automation with OCR error correction and negation handling proved not only to be rapid and convenient, but also providing consistent and reliable data abstractions from scanned clinical records. In conjunction with manual review, it can assist in the generation of high-quality data abstractions for medical research studies.

Clinicopathologic Characteristics of Endometrial Cancer in Lynch Syndrome

2017 ◽  
Vol 27 (5) ◽  
pp. 953-960 ◽  
Author(s):  
Léa Rossi ◽  
Marie-Aude Le Frere-Belda ◽  
Pierre Laurent-Puig ◽  
Bruno Buecher ◽  
Antoine De Pauw ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lynch Syndrome ◽  
Clinicopathologic Characteristics

Hysteroscopy does not increase the risk of microscopic extrauterine spread in endometrial carcinoma

2003 ◽  
Vol 13 (2) ◽  
pp. 223-227 ◽  
Author(s):  
L. Selvaggi ◽  
G. Cormio ◽  
O. Ceci ◽  
G. Loverro ◽  
A. Cazzolla ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Cancer Patients ◽  
Abdominal Cavity ◽  
Primary Diagnosis ◽  
Peritoneal Cytology ◽  
Clinicopathologic Characteristics ◽  
Diagnostic Modality ◽  
Tumor Dissemination ◽  
Positive Peritoneal Cytology

Fluid hysteroscopy has been suspected to cause tumor dissemination in the abdominal cavity in endometrial cancer patients. The aim of our study was to evaluate the incidence of microscopic extrauterine spread according to diagnostic modality (dilatation & curretage, D&C, hysteroscopy, or both) in patients with endometrial carcinoma. A retrospective study was conducted on 147 patients with histologically proven diagnosis of endometrial carcinoma without macroscopic extrauterine disease. Fluid hysteroscopy was performed by using saline solution irrigated at a final flow of 150 ml/min with a intrauterine pressure ranging between 25 and 50 mmHg. Microscopic intraperitoneal disease and positive peritoneal cytology were considered the primary end-points of this analysis. Fifty-two patients (35%) had diagnosis of endometrial cancer made only by D&C, 56 (39%) underwent D&C and then hysteroscopy, and 39 (26%) had only hysteroscopy. Distribution of the patients in this three groups was casual, and clinicopathologic characteristics of the patients in the three groups were similar. Peritoneal cytology was positive in nine patients, 13 had microscopic ovarian metastases, and eight had microscopic involvement of the pelvic peritoneum or of omentum. Neither the presence of positive peritoneal cytology nor the findings of microscopic intraperitoneal dissemination were significantly associated with the diagnostic procedure employed for primary diagnosis (D&C or D&C plus hysteroscopy or hysteroscopy alone). We conclude that fluid hysteroscopy does not increase the risk of microscopic intraperitoneal spread in endometrial cancer patients as compared to D&C.

scholarly journals ASSOCIATION OF STEROID RECEPTOR EXPRESSION WITH THE CLINICAL AND HISTOLOGICAL FINDINGS IN PATIENTS WITH ENDOMETRIAL CANCER

2021 ◽  
Vol 71 (5) ◽  
pp. 1875-79
Author(s):  
Aisha Shahid ◽  
Ghulam Haider ◽  
Paras Memon ◽  
Shumyla Beg ◽  
Mehwish Shahzadi ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Progesterone Receptor ◽  
Endometrial Carcinoma ◽  
Menopausal Status ◽  
Stage Iv ◽  
Receptor Expression ◽  
Low Grade ◽  
Endometrioid Adenocarcinoma ◽  
Histological Findings ◽  
Estrogen And Progesterone Receptor

Objective: To determine the association of estrogen and progesterone receptor expression with the clinical and histological findings of endometrial cancer. Study Design: Prospective observational study. Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi between Sep 2017 to Oct 2019. Methodology: A total of 130 patients were diagnosed with endometrial carcinoma. Data from patient files were collected regarding tumour histology, grade, stage, tumour receptor expression, and the clinical characteristics: parity, menopausal status. The receptor expression profile was documented for each patient. Data were analyzed using SPSS version 25. The association between ER/PR expression categories and clinical/histological features were explored using the chi-square test. Results: The estrogen and progesterone receptor expressions were significantly associated with low-grade (Grade I and II) tumours and with Stage I and Stage II endometrial carcinoma with p<0.001. About 34 (34.7%) cases of endometrioid histology were negative for both estrogen and progesterone receptors. The ER and PR negativity was strongly associated with Grade III endometrial cancer (p=0.003). The majority of the stage IV cancers were negative for both the ER and PR receptors with a p<0.001. Conclusion: Estrogen and progesterone positivity was associated with endometrioid adenocarcinoma, well-differentiated, and less advanced stage of endometrial cancer at the time of diagnosis.

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