Goh C, Farah BL, Ho WY, Wong SL, Goh CHR, Chew SH, Nadarajah R, Lim YK, Ho TH.
Dedifferentiated endometrioid adenocarcinoma of the uterus: A case series and review of literature.
Gynecol Oncol Rep 2020;
32:100538. [PMID:
32090165 PMCID:
PMC7025164 DOI:
10.1016/j.gore.2020.100538]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/20/2020] [Accepted: 01/26/2020] [Indexed: 12/02/2022] Open
Abstract
Dedifferentiated endometrioid adenocarcinoma is a rare aggressive subtype of endometrial cancer.
Patients tend to present at a later stage and have early recurrences.
Proportion of DEAC in endometrial cancer may affect outcome.
Further research should focus on PD-L1 expression and the use immunotherapy.
Introduction Dedifferentiated endometrioid adenocarcinoma (DEAC) was first described in 2007. However, it has only been recognised as a distinct subtype of endometrioid adenocarcinoma in the last 1–2 years. DEAC is a more aggressive histological subtype and carries a poorer prognosis. Patients with DEAC tend to present with advanced disease compared the other endometrioid adenocarcinomas. Methodology The study is a retrospective review of patients with DEAC diagnosed in two institutions in Singapore between January 2012 and October 2017. Results 7 patients were diagnosed with DEAC. The mean age was 56.4 years. All patients presented with either abnormal uterine bleeding or post menopausal bleeding. Out of the 7 patients, one was diagnosed with Stage 2 disease, 5 were diagnosed with Stage 3 disease and 1 was diagnosed with Stage 4 disease. One patient had neoadjuvant chemotherapy, followed by surgery, and completion chemotherapy post surgery. The other 6 patients (87.5%) underwent primary debulking surgery. Out of these 6 patients, 5 patients had adjuvant chemotherapy post surgery and one patient had both adjuvant chemotherapy and radiotherapy. Lymphovascular invasion was found in 71.4% of the cases. Conclusion DEAC is a more aggressive histological subtype of endometrioid adenocarcinomas. Better awareness of this condition can lead to proper diagnosis and treatment.
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