Endometrial intraepithelial carcinoma in association with polyp: review of eight cases

Abstract

BackgroundThe uterine endometrial polyp (EMP) has a potential risk of developing malignant tumors especially in postmenopausal women. These malignancies include endometrial intraepithelial carcinoma (EIC).Patients and methodsEight patients with EIC in the EMP, who were postmenopausal with ages ranging from 49 to 76 years (av. 62), were cytologically reviewed in comparison with histological findings.ResultsThe endometrial cytological findings were summarized as follows: mucous and watery diathesis as a background lacking or with little necrotic inflammatory changes; micropapillary cluster formation; abrupt transition between carcinoma cells and normal cells; nuclear enlargement; high N/C ratio; and single or a few prominent nucleoli. Histologically, one case had EIC alone in the EMP; three cases had EIC with stromal invasion confined to the EMP; and four cases had EIC in the atrophic endometrium in addition to EIC in the EMP. Seven patients have taken a disease-free course after surgical resection, but one patient died 44 months following the initial diagnosis because of the massive tumor extending over her peritoneal cavity.ConclusionsEndometrial cytology may be helpful for the detection of early endometrial adenocarcinomas with serous features including EIC. Some early stage endometrial adenocarcinomas represented by EIC exceptionally take an aggressive clinical course irrespective of a lack of extrauterine lesions.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1651876760876449

Serous Endometrial Intraepithelial Carcinoma Involving Endometrial Polyp Diagnosed by Transcervical Resection: A Case Report

“…Minimal uterine serous carcinoma is found to involve an endometrial polyp in most cases [3,8]. There is no detailed case report showing the image under hysteroscopy of the disease, thus far.…”

“…It occurs in the atrophic and resting endometrium and frequently involves endometrial polyp [3,8]. The lesion of the serous endometrial intraepithelial carcinoma is limited to the focal area in the endometrium.…”

“…The serous endometrial intraepithelial carcinoma has extrauterine tumor spread in most of diseases [3,8,12,13]. The omentum was frequently involved in most of cases.…”

“…It has been proposed to include serous carcinomas with invasion limited to the superficial endometrium, and those without stromal invasion [3]. The latter entities have been classified as serous endometrial intraepithelial carcinoma [5][6][7][8]. Noninvasive USC is called Serous Endometrial Intraepithelial Carcinoma [SEIC], and USC with limited infiltration is called Superficial Serous Carcinoma [SSC].…”

“…SEIC is thought to be a precursor lesion of serous endometrial carcinoma [9]. Recent studies have been reported that most of uterine serous intraepithelial carcinoma cases occur in the endometrial polyp [3,8,10]. Ono et al, analyzed 6 cases of uterine superficial serous carcinomas or extensive serous endometrial intraepithelial carcinomas and reported that all but 1 patient had tumors originating from the surface of polyps, including 3 patients who each had an enormous polyp occupying the entire uterine cavity [10].…”