Presentation
Lower abdominal pain.
Patient Data
The uterus and cervix are markedly enlarged and enhance heterogeneously. A large portion of the uterine fundus is hypodense. The uterus displaces the urinary bladder anteriorly and compresses it. Minute amount of free fluid abutting the uterus on the left. Small locules of air in the vaginal-cervical canal, possibly from medical instrumentation.
No evidence of metastatic dissemination.
Lumbar scoliosis with convexity to the right.
Partial collapse of T12 vertebra.
Anterolisthesis of L5 on S1. Sclerosis on both sides of the right sacroiliac joint.
Case Discussion
The uterus and vagina were biopsied.
Histopathology
Origin of sample: vagina.
Macroscopic description: a piece of gray, pliable tissue measuring 1.3 cm in diameter.
Microscopic description:
Fragments of mostly necrotic tumor. Small areas of viable hyperchromatic atypical cells were seen. These areas were diffusely positive for p53 and p16 and completely negative for ER. The proliferative index with the Ki-76 marker is about 90%. The findings may be compatible with high grade serous carcinoma.
Origin of sample: endometrium.
Macroscopic description: Mucinous material.
Microscopic description:
Small groups of hyperchromatic cells that were positive for p53 and p16 and negative for ER. Findings compatible with serous carcinoma.
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