Dedifferentiated endometrioid adenocarcinoma: An under-recognized but aggressive tumor?

Abstract

HighlightsDedifferentiated endometrioid adenocarcinoma is characterized by the coexistence of an undifferentiated carcinoma and a low-grade endometrioid adenocarcinoma.Given its histological appearance, this tumor can be mistaken for other less aggressive tumors.The possibility of undifferentiated carcinoma should be considered in endometrioid carcinoma with patterns of solid growth without appreciable glandular differentiation

Dedifferentiated endometrioid adenocarcinoma; clinicopathologic and immunohistochemical features of five cases

“…DEAC primarily occurs during the 6 th and 7 th decades; consistent with previous studies, the mean age at diagnosis in our study was 58 years ( 11 , 12 , 13 , 14 , 15 ). Similar to existing studies, all patients in our study underwent TAH+BSO and PL ( 1 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ). Advanced FIGO stage of DEAC in the literature is reported to be between 52-92%, whereas in our study, it was found as 40% ( 1 , 11 , 12 , 13 , 14 ).…”

“…Silva et al ( 1 ) described morphologic features of DEAC in 2006 and it was included in the 2014 version of the book, ‘World Health Organization Classification of the Tumors of Female Reproductive Organs’ ( 5 ). Although DEAC is generally presented as case reports, a series of such tumors was recently reported in the literature ( 6 , 7 , 8 , 9 , 10 , 11 , 12 ). DEAC primarily occurs during the 6 th and 7 th decades; consistent with previous studies, the mean age at diagnosis in our study was 58 years ( 11 , 12 , 13 , 14 , 15 ).…”

Loss of expression of SMARCA4 (BRG1), SMARCA2 (BRM) and SMARCB1 (INI1) in undifferentiated carcinoma of the endometrium is not uncommon and is not always associated with rhabdoid morphology

“…Dedifferentiated endometrial carcinoma, initially described by Silva et al ., is a tumour composed of a low‐grade endometrioid adenocarcinoma juxtaposed with an undifferentiated carcinoma . In such cases, the undifferentiated carcinoma component is thought to be derived from the endometrioid component, but the molecular mechanisms underlying this dedifferentiation are poorly understood . Undifferentiated carcinoma may also occur in a pure form (without a component of low‐grade endometrioid adenocarcinoma); in some cases, it may be that a low‐grade endometrioid adenocarcinoma component was present initially, but was completely overgrown by the undifferentiated carcinoma component.…”

“…1,2 In such cases, the undifferentiated carcinoma component is thought to be derived from the endometrioid component, but the molecular mechanisms underlying this dedifferentiation are poorly understood. 1,2,4,5 Undifferentiated carcinoma may also occur in a pure form (without a component of low-grade endometrioid adenocarcinoma); in some cases, it may be that a low-grade endometrioid adenocarcinoma component was present initially, but was completely overgrown by the undifferentiated carcinoma component. A recent study has shown that, in dedifferentiated endometrial carcinomas, the undifferentiated carcinoma component harbours similar mutations to those found in the endometrioid adenocarcinoma component, together with some additional mutations.…”

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

“…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.…”