engleski

A CASE OF EXTRA-UTERINE SPREAD IN NONINVASIVE SEROUS PAPILLARY ENDOMETRIAL CARCINOMA ARISING FROM A POLYP

Aims: To report a case of noninvasive serous papillary endometrial carcinoma with para-aortic lymph node metastases. Method: A 61 years-old nulliparous woman, with history of breast carcinoma, was admitted to our department for postmenopausal bleeding. Transvaginal ultrasonography was performed and an endometrial thickness of 6 mm was found. She underwent hysteroscopy that showed small endometrial polyp arising from the anterior uterine wall. The endometrial polyp was resected and pathological examination revealed noninvasive serous papillary carcinoma arising from the polyp. The immunohistochemical staining analysis showed negative estrogen and progesterone receptors and strong p53 overexpression. She underwent hysterectomy, bilateral salpingo-oophorectomy, omentectomy and pelvic and para-aortic lymphadenectomy. Results: The pathological finding revealed atrophic endometrium without lymphovascular space invasion and no omental or pelvic lymph node metastasis. Residual tumor was not found in the endometrium. Para-aortic lymph node metastases were present in 3 of 17 lymph nodes. Six cycles of adjuvant chemotherapy with carboplatin and paclitaxel were given. Patient is receiving radiation therapy. Conclusion: The present case emphasizes the aggressive behavior of uterine serous papillary carcinoma, along with the need for complete surgical staging including para-aortic lymphadenectomy. Extra-uterine disease spread may frequently occur even with noninvasive disease. The performance of pelvic lymphadenectomy alone represents an incomplete surgical effort resulting in failure to identify patients who may benefit from adjuvant therapy.

serous papillary endometrial carcinoma

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