Presentation
Presented with anemia, history of rectal bleeding, and a positive FIT test. 75 pound weight loss in a year. Urge incontinence.
Patient Data
The uterus is enlarged, measuring 8.5 cm AP, 13.5 cm transverse, and 20 cm
There is a 6.1 x 6.2 x 14.7 mass centered within the cervix and extending into
Uterine biopsy pathology report
Uterine curettage:
Final diagnosis - High-grade p53 mutation adenocarcinoma, consistent with serous carcinoma
Microscopic
All of the sections are similar. They show a high-grade adenocarcinoma composed of
irregular nests and cords of malignant cells with marked nuclear pleomorphism, prominent
mitotic activity, and large areas of tumor necrosis. There is some glandular and
micropapillary differentiation.
Immunostain profile:
p53 -strong diffuse positive nuclear staining
ERS- negative
WT1 - negative
p16, Napsin A, p504s - negative
This staining profile supports a diagnosis of serous carcinoma.
Case Discussion
The CT and MR findings suggest an endometrial cancer with spread to the cervix. There is local invasion of the ureters with bilateral hydronephrosis. The biopsy showed uterine serous carcinoma.
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