endometrioid adenocarcinoma

Localization

 uterine endometrioid adenocarcinoma
 ovarian endometrioid adenocarcinoma

Definition: Endometrioid adenocarcinoma has invasive nests and sheets of endometrioid glands with cribriforming. Endometrioid adenocarcinoma is positive for vimentin, ER and PR.

Images

 uterine endometrioid adenocarcinoma / uterine endometrioid carcinoma

• https://twitter.com/RikiSotillo/status/851332977367953412

 http://www.webpathology.com/image.asp?case=569&n;=3

Types

 well-differentiated endometrioid adenocarcinoma

• The glands of endometrioid adenocarcinoma are more atypical than these, and mitotic figures are more frequent.
• Furthermore, there should be evidence of invasion, such as a desmoplastic response.
• In addition, the stroma here is composed of sweeping fascicles of spindle cells.

Grade

 uterine endometrioid adenocarcinoma, FIGO grade 1
 uterine endometrioid adenocarcinoma, FIGO grade 2
 uterine endometrioid adenocarcinoma, FIGO grade 3

Differential diagnosis

 cervical adenocarcinoma

• Most endometrioid adenocarcinomas stain positive for PTEN , and cervical adenocarcinomas stain positive for p53 / TP53 , but these two markers are not enough to make the distinction.
• The combination of p53 and PTEN is of prognostic value for endometrial carcinoma.
• Endocervical adenocarcinoma is more likely positive for CEA, p16 (or EBER for HPV) and p53, but can show some positivity for ER and PR, (although the strong majority, less than 5%, will stain with both). Endometrioid adenocarcinoma is more likely to be positive for vimentin, ER and PR.
• CEA, p16, p53 IHC are more likely positive in endocervical adenocarcinoma, but other stains should be added for confirmation.

 uterine papillary serous carcinoma

• IHC p16, ER, WT-1, IMP3, p53 panel. This panel is more likely positive in ovarian papillary serous carcinoma, particularly the combination of positivity for both WT-1 and ER, compared to uterine papillary serous carcinoma.
• PTEN, p53 and IMP3 are more likely positive in uterine serous papillary carcinoma compared to endometrioid adenocarcinoma.

IHC

 p53 / TP53

• Most serous adenocarcinomas, and high grade endometrioid adenocarcinomas are positive for p53 - p53 staining is correlated with worse prognosis.

 PTEN

• PTEN is the opposite.
• Loss of PTEN staining (linked to PTEN mutations) is associated with microsatellite instability ( MSI ) and a favorable prognosis.
• PTEN is also more likely positive in serous carcinoma.

See also

 endometrioid carcinoma
 endometrioid tumors
 endometrial carcinomas