Endometrioid adenocarcinoma

Solitary fibrous tumor, synovial sarcoma, hepatic adenoma, neuroendocrine carcinoma, GIT adenocarcinomas, endometrioid carcinoma, cholangiocellular carcinoma... 

Epithelial ovarian tumors are composed of cells that cover the surface of the ovary, such as serous, mucinous, endometrioid, clear cell, and poorly differentiated adenocarcinomas. 

Blechschmidt K, Kremmer E, Hollweck R, et al. The E-cadherin repressor snail plays a role in tumor progression of endometrioid adenocarcinomas. Diagn. Mol. Pathol. 2007 16 222-228. 

While the risk that hormone replacement therapy may cause endometrial tumors has been widely discussed, less attention has been given to the possibility that it could increase the risk of epithelial ovarian cancer. Since cancer of the ovary has some risk factors in common with endometrial cancer (notably low parity and obesity), this possible risk needs to be considered, especially in view of the fact that the endometrioid epithelial type of ovarian tumor is histologically so similar to adenocarcinoma of the endometrium. 

Vimentin coexpression is especially useful in differentiating endometrial endometrioid carcinomas in uterine curettage specimens from endocervical adenocarcinomas including the endometrioid variant of endocervical adenocarcinoma. Endometrial endometrioid carcinomas immunostain strongly for vimentin, but endocervical carcinomas rarely stain (weak focal staining in up to 13% of endocervical carcinomas). i > i However, with the current antigen retrieval techniques, moderate to occasionally strong vimentin expression may be seen in endocervical carcinomas, and a panel approach is more useful in this distinction. ... 

A prior study has reported uterine cervical adenocarcinomas with intestinal features to be negative for both CDX2 and CK20, but a few recent studies have shown nuclear CDX2 immunoreactivity in up to 30% of cervical adenocarcinomas. This immunoreactivity is seen not only with rniillerian mucinous or intestinal mucinous differentiation but also in endometrioid tumors of the uterine cervix. However, dominant CK7 reactivity is useful in determining gynecologic origin. 

Endometrioid adenocarcinomas of the ovary and the uterus are CDX2-I- in up to 25% of cases. 

Dabbs DJ, Sturtz K, Zaino RJ. The immunohistochemical discrimination of endometrioid adenocarcinomas. Hum Pathol. 1996 27 172-177. 

Jones MW, Onisko A, Dabbs DJ, et al. The value of immuno-histochemistry in distinction between endocetvical adenocat-cinoma and adenocarcinoma of endometrium, endometrioid type. A comparative tissue microattay study of 76 cases. In-tetnational Academy of Pathology. 2008 XXVII Intetnational Congtess Abstract. 

Lee SS. Endometrioid adenocarcinoma of the prostate a clini-copathologic and immunohistochemical study. I Surg Oncol. 1994 55 235-238. 

Millar EK, Sharma NK, Lessells AM. Ductal (endometrioid) adenocarcinoma of the prostate a clinicopathological study of 16 cases. Histopathology. 1996 29 11-19. 

FIGURE 14.25 Colorectal adenocarcinoma versus mullerian endometrioid adenocarcinoma. 

Colon versus mullerian endometrioid adenocarcinoma. Antibodies CK7, CK20, CEA, CDX2, ER (Fig. 14.25). CK7 is a useful initial antibody because it is positive in greater than 95% of endometrioid adenocarcinomas and minimally reactive in colorectal adenocarcinomas. Conversely, CK20 is nonreactive in endometrioid adenocarcinomas and positive in... 

Bostwick DC, Kindrachuk RW, Rouse RV. Prostatic adenocarcinoma with endometrioid features. Clinical, pathologic, and ultrastructural findings. Am J Surg Pathol. 1985 9 595. 

Epstein JI, Woodruff JM. Adenocarcinoma of the prostate with endometrioid features. A light microscopic and immunohisto-chemical study of ten cases. Cancer. 1986 57 111. 

FIGURE 18.9 Primary endocervical adenocarcinoma may mimic primary endometriai endometrioid adenocarcinoma (A). (H E.) Monocionai CEA (B) and pi 6 (C) are diffuseiy and strongiy expressed. Estrogen receptor (D) and vimentin (E) are not expressed, aithough the stroma may be vimentin positive. Primary endometriai adenocarcinoma typicaiiy exhibits the converse pro-fiie for these four markers, aithough overiap may occur in some cases. 

Except in FICO grade 3 endometrioid adenocarcinoma, about 50% of which express significant ER and PR these also tend to be more proliferative than grade 1 and 2 carcinomas. 

FIGURE 18.14 Markers of emerging importance in distinguishing uterine endometrioid carcinoma and uterine serous carcinoma include p33, p-catenin, and PTEN. While serous carcinomas characteristically overexpress p53 (A), endometrioid adenocarcinomas, especially when gland-forming, frequently express estrogen receptors (B), commonly show at least focal nuclear and cytoplasmic staining with anti-P-catenin (C), and lose expression of PTEN (D). 

More detailed discussion of ER, PR, p53, and DNA MMR can be found in the Theranostic Applications section. Finally, it should be noted that while many endometrioid adenocarcinomas of endometrium... 

FIGURE 18.16 p53 immunohistochemical staining can be used when the differential diagnosis includes uterine serous carcinoma (USQ and uterine endometrioid carcinoma (UEC). USC shows diffuse and intense nuclear immunoreactivity for p53 (A, B), as does the USC precursor EIC (C, D). Not infrequently, USC can demonstrate a glandular architectural pattern (E). Diffuse and intense p53 immunoreactivity in glandular use (F) can provide support for this entity when simple atypical hyperplasia and endometrioid adenocarcinoma are considerations. 

FIGURE 18.23 Cytokeratin subsets in primary epithelial tumors. (A) Primary epithelial tumors usually exhibit diffuse strong staining for CK7, like this endometrioid adenocarcinoma. (B) Except for mucinous tumors, primary epithelial tumors do not stain for CK20. 

FIGURE 18.32 Small cell carcinoma of neuroendocrine type. This tumor arose in association with an endometrioid adenocarcinoma. The tumor cells are strongly positive for NSE. 

Colorectal adenocarcinoma is the most frequent metastasis, and it can mimic endometrioid and mucinous adenocarcinoma of the ovary. 

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