Uncommon and Difficult High-Grade Endometrial Carcinomas

Special Considerations in Classification and Workup of Endometrial Carcinomas

CONTEXT.—

A variety of uncommon malignant endometrial tumors can be challenging to diagnose because of overlapping morphology with more common entities. In some cases, immunohistochemical stains and/or molecular testing allow for more definitive diagnosis or prognostication.

OBJECTIVE.—

To review classic morphologic features of uncommon endometrial tumors, pathologic features of these tumors and their mimics, and the evidence for use of immunohistochemistry and molecular testing in the diagnosis of these tumors.

DATA SOURCES.—

University of Michigan (Ann Arbor) cases and review of pertinent literature about each entity.

CONCLUSIONS.—

Although each of these uncommon endometrial tumors has morphologic mimics, key histologic features, immunohistochemical stains, and molecular testing allow for accurate classification.

Dedifferentiated endometrial carcinoma arising from serous carcinoma: Diagnostic challenges and recommendations

•Dedifferentiated endometrial carcinoma arising from serous carcinoma (null-type P53).•Differential diagnosis including carcinosarcoma, FIGO grade 3 endometrioid carcinoma.•Also need to rule out SMARCA4-deficient uterine sarcoma and other sarcomas.