Intestinal type adenocarcinoma of the endometrium with signet ring cells, a rare aggressive variant.
Gynecol Oncol Rep 2022;
42:101046. [PMID:
35898198 PMCID:
PMC9309656 DOI:
10.1016/j.gore.2022.101046]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/10/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022] Open
Abstract
Intestinal type mucinous adenocarcinoma is a rare variant of mucinous carcinoma of the endometrium.
Intestinal differentiation in the endometrium can manifest with a wide spectrum of morphologies including signet-ring cells.
E-cadherin expression is downregulation in the signet-ring cell component in all three cases.
Cases described provides further evidence of the aggressive nature of intestinal type mucinous adenocarcinoma.
Objective
Intestinal type mucinous adenocarcinoma (iMACE) is a rare and unusual variant of mucinous carcinoma of the endometrium that can show focal features of poorly differentiated adenocarcinomas of gastric, pancreatic or intestinal origin by producing signet ring cells. To date, only two reported cases of signet ring cells as a morphological feature of iMACE have been reported. Alterations in E-cadherin expression have been linked to increased metastatic potential, tumor dedifferentiation, and deep myometrial invasion in endometrial carcinomas. The presence or absence of E-cadherin in iMACE with signet-ring cells has not been studied. Thus, we sought to analyze E-cadherin expression in this aggressive variant of endometrial carcinoma.
Cases
Diagnosis of iMACE with signet ring cells was rendered with the aid of immunohistochemical staining and histological analysis. Average age of diagnosis was 72 with the presenting complaint of postmenopausal bleeding in all three women. Focal loss or weakly positive E-cadherin expression was seen in areas of signet-rings cell morphology in all three cases.
Conclusion
This case report adds to the body of literature that demonstrates the aggressive nature of intestinal differentiation in the endometrium. In addition, this report suggests that the presence of signet-rings cells and loss of E-cadherin expression may render a poorer prognosis as seen in other parts of the body.
Collapse