Dedifferentiated endometrial carcinoma: A report of three cases and review of the literature

Abstract

Abstract. Dedifferentiated endometrial carcinoma, which is defined microscopically as the co-existence of undifferentiated carcinoma and grade 1 or 2 endometrioid adenocarcinoma, is an aggressive type of cancer regardless of the percentage of undifferentiated components. It is reported that undifferentiated carcinoma comprises 9% of endometrial carcinoma. The percentage of dedifferentiated endometrial carcinoma has been hypothesized to be 40% of undifferentiated carcinoma. A precise pathological diagnosis is essential for defining the appropriate therapeutic approach and prognosis. Furthermore, since there is an association between dedifferentiated endometrial carcinoma and Lynch syndrome, it is important to identify the patient's genetic background. The current case report presents three cases of dedifferentiated endometrial carcinoma treated in our hospital. In immunohistochemical staining for DNA mismatch-repair (MMR) proteins in dedifferentiated endometrial carcinoma, the components of undifferentiated carcinoma demonstrated a loss of MMR protein expression, and it is suspected that there may be a germline mutation in these cases. Therefore, Lynch syndrome should be suspected and the appropriate genetic approaches in cases of dedifferentiated endometrial carcinoma should be considered.

Ovarian mucinous tumors with mural nodules: immunohistochemical and molecular analysis of 3 cases

“…Dedifferentiation is well-established in soft tissue and bone tumors, and more recently in epithelial tumors. Dedifferentiation is not uncommon in uterine or ovarian endometrioid carcinoma, and typically associated with an aggressive clinical course [17]. The dedifferentiation conception in anaplastic nodules is supported by our molecular and immunohistochemical analysis.…”

Two Cases of Dedifferentiated Endometrioid Carcinoma: Case Presentation and Brief Review of the Literature

“…Preoperative diagnosis of DEC is difficult by only endometrial curettage [ 8 ]. Our literature review showed that almost all cases were diagnosed by surgical specimens and only two cases were diagnosed by endometrial biopsy.…”

“…An association between DEC and Lynch syndrome has been previously reported [ 6 ]. Yokomizo et al examined the immunohistochemistry for DNA mismatch-repair (MMR) proteins in three cases diagnosed as DEC and demonstrated the loss of MMR protein expression in the UC components of these patients [ 8 ]. Thus, the authors emphasized the importance of assessing the genetic background of patients with DEC.…”

Endometrial dedifferentiated carcinoma: a case report. Pathological review at a single institution and systematic review of published literature

“…No reports systematically explored the efficacy of treatment such as surgery and adjuvant therapy [8,13,19]. Therefore, the present authors aimed to systematically review and investigate appropriate treatments, using current available information.…”

“…Several reports have demonstrated the clinical outcome regarding DC [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. DC has been assumed to be an aggressive tumor that induces a poor clinical outcome regardless of aggressive treatment that includes surgery and chemotherapy.…”