A case report of corded and hyalinized endometrioid carcinoma of the serous surface of the uterus in the context of endometriosis in a 45-year-old woman

Articles in Press

Document Type : Case report

Authors

1 professor of mashhad university of medical science

2 Pathology resident of mashhad university of medical science

3 OBSTETRICS AND GYNECOLOGY DEPARTMENT, MASHHAD UNIVERCITY OF MEDICAL SCIENCE

4 associated professor of mashhad university of medical science

5 pathology resident of mashhad university of medical science

10.22038/ijogi.2025.83502.6240

Abstract

Endometriosis is presence of endometrial tissue outside of endometrium and myometrium. Peak incidence is 30-45 years of age. Risk of development of malignant neoplasm is estimated at 1-2.5% (mostly endometrioid carcinoma).

corded and hyalinized endometrioid carcinoma is rare variants of endometrioid carcinoma that mean age was 49 years and characterized by cords of atypical epithelial cells within a hyalinized stroma, that merge with conventional low-grade EC. Most cases showed low grade, and a favorable outcome, with no specific molecular profile.

45 years old woman presented with abdominal pain and flatus. In the experiments, CA19-9 and CA125 were high and in ultrasound, the echo mixed solid-cystic mass was reported in the right adenex adjacent to the uterus fundus. CT scan show heterogeneous enhancer mass containing solid cystic segments in the right adenex attached to the right side of the uterus. The patient underwent uterine serous surface mass resection, hysterectomy and bilateral salpingo-oophorectomy. The uterine mass in microscopic examination, show in the background of endometriosis, atypical epithelioid cells were observed as chords and cells aggregations in the context of hyalineized stroma. In the immunohistochemistry study, PAX8, ER, and CK were positive, which is generally in favor of CHEC.

Given the rarity of CHEC there is possibility of misdiagnosis based on histopathology, and due to their “biphasic” morphology, these tumors are often misdiagnosed as other biphasic endometrial malignancies especially carcinosarcoma. Therefor it should be considered in endometrioid carcinoma and biphasic tumors such as carcinosarcoma.

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The Iranian Journal of Obstetrics, Gynecology and Infertility

Articles in Press, Accepted Manuscript
Available Online from 22 February 2025

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