Endometrial carcinoma - transcoelomic spread (pathology)

Case contributed by Dr Andrew Ryan

Presentation

Patient presented with large bowel obstruction, 12 months after a hysterectomy for endometrial carcinoma.

Patient Data

Age: 80 years
Gender: Female

The patient underwent laparotomy where the following piece of omentum was removed. Additional deposits were noted elsewhere on the peritoneum.

The macroscopic and microscopic findings confirm the presence of peritoneal deposits of serous papillary carcinoma, in keeping with endometrial origin. 

Low power: omental fat with fibrous bands and infiltrative glands.

High power: localized glands show serous papillary morphology.

Case Discussion

This case demonstrates the potential of adenocarcinoma from the endometrium to spread within the celomic cavity via transperitoneal route, even in the setting of a previously organ confined tumor. In this case, the patient had a past history of high grade endometrial carcinoma and although the histological typing was not available, serous papillary carcinoma is a common sub-type of endometrial carcinoma in this age group. Immunohistochemical stains showed the tumor cells to be positive for the epithelial marker CK7 and estrogen receptor (ER), and negative for the differential cytokeratin CK20. 

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