Endometrial Serous Carcinoma Arising from Adenomyosis: A Clinico-Pathological Insight

Amrita Talwar; Pushpanjali Behera; Arvind Ahuja; Bani Sarkar; Ravi Hari Phulware

doi:10.18502/jfrh.v15i2.6454

Amrita Talwar Department of Pathology, Postgraduate Institute of Medical Sciences, Ram Manohar Lohia Hospital, New Delhi, India
Pushpanjali Behera Department of Pathology, Postgraduate Institute of Medical Sciences, Ram Manohar Lohia Hospital, New Delhi, India
Arvind Ahuja Department of Pathology, Postgraduate Institute of Medical Sciences, Ram Manohar Lohia Hospital, New Delhi, India
Bani Sarkar Department of Obstetrics & Gynecology, Postgraduate Institute of Medical Sciences, Ram Manohar Lohia Hospital, New Delhi, India
Ravi Hari Phulware Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India

DOI: https://doi.org/10.18502/jfrh.v15i2.6454

Keywords: Endometrial neoplasms; Adenomyosis; Menopause; Carcinoma in situ; Endometrium; Carcinoma

Abstract

Objective: Endometrial cancer (EC) is the most commonly diagnosed malignancy and has the secondhighest mortality rate among gynecological cancers. Adenomyosis is well-known for abnormal uterine bleeding and is a widely reported entity; however, an EC arising from the adenomyosis is a rare event; even rarer is the occurrence of serous endometrial carcinoma.

Case report: A 60-year post-menopausal female presented with post-menopausal bleeding. Subsequently, she underwent a hysterectomy, which showed atrophic and cystic endometrium with extensive adenomyosis and atypical endometrial glands, which are diffusely P53 positive with intervening negative benign and focally positive dysplastic endometrial glands. A final diagnosis of serous endometrial carcinoma arising from adenomyosis was rendered. In a table format, previously reported serous endometrial carcinoma Arising cases from adenomyosis using PubMed search had been described.

Conclusion: Serous endometrial carcinoma arising from adenomyosis (<20 cases reported) and has a slightly more dismal prognosis than those deriving from the endometrial cavity. Hence, this case report highlights the occurrence, rarity, and importance of such an entity.