Rare brain metastasis with unusual characteristics in a late recurrence of stage IIIA uterine papillary serous carcinoma

Uterine papillary serous carcinoma (UPSC) is a rare endometrial neoplasm with high mortality rates. While the malignancy has often metastasized to distant organs by the time of diagnosis, brain lesions are extremely rare and most commonly only observed in widely disseminated disease. Here, we present an unusual case of UPSC with brain metastasis discovered six years after undergoing treatment for stage IIIA disease. Compared to the few previous cases of brain metastasis from UPSC, this lesion exhibited unusual imaging characteristics. We also highlight a potential imaging interpretation pitfall which was associated with this case.

TXNDC17 Protein Overexpression in Uterine Papillary Serous Carcinoma is Associated with Chemoresistance

Background: TXNDC17(thioredoxin domain containing 17 protein) has primarily been associated with ovarian cancer. It concurs resistance to paclitaxel by inducing autophagy. However, limited information exists on its role in uterine papillary serous carcinoma (UPSC). This study aimed to analyze clinicopathological characteristics of patients with UPSC in China, and investigate roles of TXNDC17 protein in UPSC chemoresistance and prognosis. Methods: Fifty-five patients with UPSC treated in women’s hospital school of medicine Zhejiang university from 2003 to 2016 were analysed retrospectively. Immunohistochemistry (IHC) were performed to TXNDC17 and BECN1 (Beclin 1 protein, a key regulator of autophagy) protein expression respectively. Results: A total of 55 UPSC patients of median age (63.3 years), 43.7% with late stages (stage III/IV), and 48.6 % exhibiting more than half of myometrium invasion were enrolled. Notably, 28 (50.9%) patients had TXNDC17 protein overexpression associated with chemoresistance and high BECN1 expression. BECN1 overexpression occurred at an advanced stage and was characterized by deep myometrial invasion. Of note, advanced stage, deep myometrial invasion, BECN1, and TXNDC17 overexpression were significantly associated with a poor outcome. Besides, co-expression of TXNDC17 and BECN1 occurred at an advanced stage causing deep myometrial invasion and chemoresistance thereby resulted in the shortest survival in UPSC. The multivariate proportional hazards model revealed that myometrial invasion and TXNDC17 overexpression were independent prognostic factors. Conclusion: This study showed that TXNDC17 overexpression, through induces autophagy, and consequently results in chemoresistance and poor survival in UPSC patients. TXDNC17 may be a potential predictor or target in UPSC therapeutics.