scholarly journals Undifferentiated Endometrial Carcinoma: A Diagnosis Frequently Overlooked

2013 ◽  
Vol 137 (3) ◽  
pp. 438-442 ◽  
Author(s):  
Shaymaa Al-Loh ◽  
Maysa Al-Hussaini
Keyword(s):  
Endometrial Carcinoma ◽  
Cancer Center ◽  
Endometrioid Adenocarcinoma ◽  
Diagnostic Challenge ◽  
Gynecology And Obstetrics ◽  
Proper Definition ◽  
Grade 3 ◽  
Md Anderson ◽  
Endometrial Endometrioid Adenocarcinoma ◽  
Uncommon Neoplasm

Undifferentiated endometrial carcinoma (UEC) is a relatively uncommon neoplasm with only few studies published thus far. It has always been a diagnostic challenge because of the lack of proper definition cited in most of the standard textbooks. Recently however, a few studies have highlighted the clinicopathologic features of UEC. The distinctive morphology of UEC was noted by the group from MD Anderson Cancer Center, which enabled them to establish the defining criteria. It appears to be more aggressive than endometrial endometrioid adenocarcinoma, FIGO (International Federation of Gynecology and Obstetrics) grade 3, its main differential diagnosis. Proper recognition of this entity is important owing to its aggressive behavior.

scholarly journals Concurrent Malignant Solitary Fibrous Tumor Arising from the Omentum and Grade 3 Endometrial Endometrioid Adenocarcinoma of the Uterus withp53Immunoreactivity

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Naoya Harada ◽  
Ichiro Nobuhara ◽  
Noriko Haruta ◽  
Yumi Higashiura ◽  
Hideki Watanabe ◽  
...  
Keyword(s):  
Solitary Fibrous Tumor ◽  
Vaginal Discharge ◽  
Endometrioid Adenocarcinoma ◽  
Resonance Imaging ◽  
Uterine Corpus ◽  
First Case ◽  
Grade 3 ◽  
Fibrous Tumor ◽  
Endometrial Endometrioid Adenocarcinoma ◽  
Secondary Malignant Tumor

A malignant solitary fibrous tumor arising from the omentum is extremely rare. To our knowledge, this is the first case of a malignant solitary fibrous omentum tumor coexisting with uterine corpus cancer. A 62-year-old woman presented to our hospital with vaginal discharge. Endometrioid adenocarcinoma was diagnosed by endometrial curettage. In addition, a solid tumor in front of the uterus was detected following computed tomography and/or magnetic resonance imaging, which was suspected to be a primary (or secondary) malignant tumor arising from the omentum. Hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and lymphadenectomy were performed. A malignant solitary fibrous tumor of the omentum and grade 3 endometrioid adenocarcinoma of the uterus were diagnosed by pathohistological analysis. Interestingly, the tumor cells were immunoreactive forp53. Adjuvant chemotherapy was administered for the uterine corpus cancer and the patient remains healthy 48 months after the surgery. These tumors may have become malignant due to the presence ofp53mutations.

scholarly journals Interobserver Variability in the Diagnosis of Uterine High-Grade Endometrioid Carcinoma

2016 ◽  
Vol 140 (8) ◽  
pp. 836-843 ◽  
Author(s):  
Sumi Thomas ◽  
Yaser Hussein ◽  
Sudeshna Bandyopadhyay ◽  
Michele Cote ◽  
Oudai Hassan ◽  
...  
Keyword(s):  
New York ◽  
Interobserver Variability ◽  
Serous Carcinoma ◽  
Cancer Center ◽  
Endometrioid Adenocarcinoma ◽  
High Grade ◽  
Diagnostic Agreement ◽  
Agreement Rate ◽  
Nuclear Atypia ◽  
Gynecology And Obstetrics

Context.—Low interobserver diagnostic agreement exists among high-grade endometrial carcinomas. Objective.—To evaluate diagnostic variability in International Federation of Gynecology and Obstetrics (FIGO) grade 3 endometrioid adenocarcinoma (G3EC) in 2 different sign-out practices. Design.—Sixty-six G3EC cases were identified from pathology archives of Wayne State University (WSU, Detroit, Michigan) (general surgical pathology sign-out) and 65 from Memorial Sloan Kettering Cancer Center (MSK, New York, New York) (gynecologic pathology focused sign-out). Each case was reviewed together by 2 gynecologic pathologists, one from each institution, and classified into the G3EC group or a reclassified group. Clinicopathologic parameters were compared. Results.—Twenty-five WSU cases (38%) were reclassified as undifferentiated (n = 2), serous (n = 4), mixed endometrioid and serous carcinomas (n = 12), and FIGO grade 2 endometrioid adenocarcinomas with focal marked nuclear atypia (n = 7). Eleven MSK cases (17%) were reclassified as undifferentiated (n = 5), serous (n = 1), mixed endometrioid and serous carcinomas (n = 4), and mixed endometrioid and clear cell carcinomas (n = 1). Agreement rate between original and review diagnosis was 83% (54 of 65) at MSK and 62% (41 of 66) at WSU (P = .01) with an overall rate of 73% (95 of 131). There were more undifferentiated carcinomas at MSK than there were at WSU (45% [5 of 11] versus 8% [2 of 25]; P = .02). There were more grade 2 endometrioid adenocarcinomas with focal, marked nuclear atypia at WSU (28%; 7 of 25) than there were at MSK (0%) (P = .03). Mixed endometrioid and serous carcinoma was the most common misclassified subtype (44%; 16 of 36). Conclusion.—Moderate interobserver variability exists in the diagnosis of G3EC with a significantly greater diagnostic agreement rate in gynecologic pathology–focused sign-out than in general sign-out practice.

Significance of p27 as a predicting marker for medroxyprogesterone acetate therapy against endometrial endometrioid adenocarcinoma

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 452-457 ◽  
Author(s):  
J. Watanabe ◽  
K. Watanabe ◽  
T. Jobo ◽  
Y. Kamata ◽  
M. Kawaguchi ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Medroxyprogesterone Acetate ◽  
Early Stage ◽  
Endometrial Adenocarcinoma ◽  
Endometrioid Adenocarcinoma ◽  
Nuclear Staining ◽  
Adenocarcinoma Cells ◽  
Clinical Responses ◽  
Effective Group ◽  
Endometrial Endometrioid Adenocarcinoma

Watanabe J, Watanabe K, Jobo T, Kamata Y, Kawaguchi M, Imai M, Okayasu I, Kuramoto H. Significance of p27 as a predicting marker for medroxyprogesterone acetate therapy against endometrial endometrioid adenocarcinoma. Int J Gynecol Cancer 2006;16(Suppl. 1): 452–457.We reported that p27 induced by medroxyprogesterone acetate (MPA) may be involved in the progestin-induced growth suppression of human endometrial adenocarcinoma cells. This study aimed at investigating whether p27 expression could be a predicting marker to evaluate the effectiveness of MPA therapy. The clinical responses of 15 patients with endometrial carcinoma treated with MPA were examined. p27 expression was evaluated by immunohistochemical staining. Percentage of positive nuclear staining was expressed as a strongly positive (SP) labeling index (LI). Before MPA treatment, SP LIs in the effective and noneffective groups were 22.6 ± 14.3% and 9.1 ± 9.2%. At 1–6 weeks in the MPA treatment, SP LIs increased in both groups and were significantly higher than those before the therapy. At 7–12 weeks, SP LIs in both groups decreased to the level of pretherapy. At 13–18 weeks, SP LIs in the effective group were 14.9 ± 5.7%, whereas in the noneffective group, 1.1 ± 2.0%. The former was significantly higher than the latter. p27 expression could predict the effectiveness of MPA treatment for endometrial carcinoma at an early stage of the 4-month period in MPA therapy and could be a useful predicting marker for MPA.

scholarly journals 280 Clinical outcomes of immunotherapy continued beyond radiographic progression in older adults with advanced non-small cell lung cancer

2021 ◽  
Vol 9 (Suppl 3) ◽  
pp. A304-A304
Author(s):  
Eric Singhi ◽  
Frank Mott ◽  
Michelle Worst ◽  
Cheuk Hong Leung ◽  
Jack Lee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Older Adults ◽  
Clinical Outcomes ◽  
Median Duration ◽  
Advanced Nsclc ◽  
Cancer Center ◽  
University Of Texas ◽  
Grade 3 ◽  
Md Anderson ◽  
The University

BackgroundWhile the clinical outcomes of immune checkpoint inhibitor (ICI) use in older adults with advanced-stage non-small cell lung cancer (NSCLC) have been described, the role of ICI use continued beyond disease progression (BDP) remains to be well defined for this population. This retrospective single-center study explored the clinical outcomes of continuing ICIs BDP among older adult patients with advanced NSCLC.MethodsUsing MD Anderson’s Gemini Lung Cancer database, we retrospectively reviewed the clinical outcomes of older adults (≥70 years) diagnosed with advanced-stage NSCLC treated with anti-PD-(L)1 monotherapy from March 2015 through April 2019 to correlate clinicopathologic features with clinical outcomes. Clinical therapy responses were evaluated by Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1). Toxicities were assessed using Common Terminology Criteria for Adverse Events (CTCAE), version 5. Patients treated BDP were defined as individuals receiving ICIs for ≥8 weeks prior to documentation of progression who subsequently remained on ICIs for ≥6 weeks.ResultsOf the 159 older adults meeting the inclusion criteria, 33 (21%) received ICIs BDP (64% male, median age 74.9 years (70.1–82.0) at the start of ICI treatment, 3 received first-line ICI therapy). Most patients were former (85%) or current (6%) smokers. 79% had adenocarcinoma histology. The median duration of immunotherapy continued BDP was 7.1 months (95% CI: 3.0–8.2). After a follow-up of 30.1 months, the median overall survival (mOS) was 31.5 months (95% CI: 16.5-not reached). Eight (24%) received local consolidative radiotherapy with a median duration of ICI BDP of 8.2 months (95% CI: 1.9–13.3). Twenty-five (76%) did not receive local consolidative therapy and achieved a median duration of ICI BDP of 4.1 months (95% CI: 2.3–7.8). Six (18%) exhibited pseudo-progression (i.e. delayed response to immunotherapy with decreased tumor burden on subsequent radiologic studies), with 4 achieving ”stable disease” as best response and 2 achieving a partial response. The median duration of immunotherapy continued beyond pseudo-progression was 11.7 months (95% CI: 7.1–35.7), and the mOS was 26.2 months (95% CI: 16.5–40.0). Patients treated with ICI BDP most commonly experienced fatigue (18%), pneumonitis (12%), rash (9%), and hypothyroidism (9%). Three patients (9%) experienced grade 3 or higher toxicities (one grade 3 arthralgias and two grade 3 pneumonitis).ConclusionsICI-use BDP in older adults with advanced NSCLC may benefit a subset of patients. Additionally, local consolidative therapy with radiation may offer prolonged duration of ICI treatment.AcknowledgementsSupported by the generous philanthropic contributions to The University of Texas MD Anderson Lung Moon Shot Program and the MD Anderson Cancer Center Support Grant P30 CA01667. Special acknowledgment to the GEMINI team.Ethics ApprovalThis study was approved and conducted in accordance with the institutional review board at the University of Texas MD Anderson Cancer Center; approval number (PA13-0589).

scholarly journals Sonographic Presentation of Endometrial Carcinoma Stage I: A Case Study

2018 ◽  
Vol 34 (4) ◽  
pp. 292-297
Author(s):  
Nathalie Castaneda
Keyword(s):  
Endometrial Carcinoma ◽  
Reproductive Tract ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Figo Stage ◽  
Endometrial Biopsy ◽  
Female Reproductive Tract ◽  
Endometrioid Adenocarcinoma ◽  
Gynecology And Obstetrics ◽  
Conclusive Diagnosis

Endometrial carcinoma is the most commonly diagnosed malignancy in the female reproductive tract, mainly affecting women in their postmenopausal years. Although rare, it can also present in premenopausal women. The most common clinical presentation is episodes of abnormal uterine bleeding. Magnetic resonance imaging (MRI), computed tomography (CT), and sonography are imaging modalities used to detect endometrial carcinoma. However, a conclusive diagnosis is made through endometrial biopsy. A case is reported of endometrial distension with endometrial carcinoma and cervical stenosis listed as differentials and originally detected through CT. Sonographic assessment showed an irregular thickened endometrium and an endometrial cavity containing fluid with low-level echoes and areas of polypoid mass-like tissue. Based on these findings, the patient underwent an endometrial biopsy that provided confirmation of endometrioid adenocarcinoma (International Federation of Gynecology and Obstetrics [FIGO] Stage 1).

Role of adjuvant chemotherapy in patients with FIGO stage IB grade 3 endometrial endometrioid adenocarcinoma treated with surgery and post-operative radiotherapy

2021 ◽  
pp. ijgc-2021-002380
Author(s):  
Leonid B Reshko ◽  
Jeremy T Gaskins ◽  
Sara M Dryden ◽  
Daniel S Metzinger ◽  
Sarah L Todd ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Radiotherapy ◽  
Cox Model ◽  
Figo Stage ◽  
Endometrioid Adenocarcinoma ◽  
Stage Ib ◽  
Grade 3 ◽  
Endometrial Endometrioid Adenocarcinoma ◽  
Lymphovascular Space Invasion

BackgroundThe optimal treatment of patients with FIGO stage IB grade 3 endometrial endometrioid adenocarcinoma remains unknown.ObjectiveTo compare overall survival following treatment with a hysterectomy and adjuvant radiotherapy with or without chemotherapy in this group of patients.MethodsPatients diagnosed between January 2004 and January 2016 with FIGO stage IB grade 3 endometrial endometrioid adenocarcinoma treated with hysterectomy and postoperative radiotherapy with or without adjuvant concurrent chemotherapy were identified in the National Cancer Database. Overall survival was assessed with Kaplan-Meier curves. A Cox model was constructed to evaluate survival after controlling for confounding variables. A logistic regression model was used to reveal predictors of chemotherapy use.ResultsA total of 2173 patients were included. The receipt of chemotherapy was associated with an increased 5-year overall survival from 67.6% to 75.6% (p=0.0313). This association trended toward statistical significance on multivariate analysis (adjusted HR (aHR) 0.80; 95% CI 0.63 to 1.01; p=0.0653). Other factors associated with improved survival were undergoing a lymphadenectomy, absence of lymphovascular space invasion, younger age, smaller tumor size, non-black race, and absence of comorbidities. Patients who underwent brachytherapy, had lymphovascular space invasion, were younger, were diagnosed in the more recent years, and were treated in higher volume centers were more likely to receive adjuvant chemotherapy.ConclusionAdjuvant chemotherapy and radiation therapy were associated with an increase in survival in patients with FIGO stage IB grade 3 endometrial endometrioid adenocarcinoma compared with those treated with adjuvant radiotherapy alone.

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