TY - JOUR
T1 - Postchemotherapy Endometrioid to Gastrointestinal Histotype Shift in Recurrent Endometrial Carcinoma
AU - Arciuolo, Damiano
AU - Travaglino, Antonio
AU - Santoro, Angela
AU - Pedone Anchora, Luigi
AU - Inzani, Frediano
AU - Angelico, Giuseppe
AU - D’Alessandris, Nicoletta
AU - Scaglione, Giulia
AU - Valente, Marianna
AU - Raffone, Antonio
AU - Fanfani, Francesco
AU - Zannoni, Gian Franco
PY - 2022
Y1 - 2022
N2 - Herein, we report a case of low-grade endometrial endometrioid carcinoma recurred on the vaginal stump, which showed a complete histotype shift toward a gastrointestinal-type carcinoma after chemotherapy. The recurrent tumor increased in volume during chemotherapy. Postchemotherapy histologic examination showed a pure mucinous signet-ring cell pattern with positivity for cytokeratin 20 and CDX2, focal SATB2 expression and negativity for cytokeratin 7 and estrogen and progesterone receptors. Such features led to consider a diagnosis of metastasis from a primary carcinoma of the gastrointestinal tract. The accurate exclusion of any primary lesions of gastrointestinal and of other sites allowed identifying the tumor as the recurrent endometrial carcinoma. Our case highlights that chemotherapy may induce a histotype shift from endometrioid carcinoma to gastrointestinal-type carcinoma; such occurrence might be a mechanism of resistance and might provide new insights on the sensitiveness of different histotypes to systemic therapies. Considering the possibility of a shift from endometrioid to gastrointestinal-type carcinoma may be useful for a correct diagnosis and an appropriate patient management.
AB - Herein, we report a case of low-grade endometrial endometrioid carcinoma recurred on the vaginal stump, which showed a complete histotype shift toward a gastrointestinal-type carcinoma after chemotherapy. The recurrent tumor increased in volume during chemotherapy. Postchemotherapy histologic examination showed a pure mucinous signet-ring cell pattern with positivity for cytokeratin 20 and CDX2, focal SATB2 expression and negativity for cytokeratin 7 and estrogen and progesterone receptors. Such features led to consider a diagnosis of metastasis from a primary carcinoma of the gastrointestinal tract. The accurate exclusion of any primary lesions of gastrointestinal and of other sites allowed identifying the tumor as the recurrent endometrial carcinoma. Our case highlights that chemotherapy may induce a histotype shift from endometrioid carcinoma to gastrointestinal-type carcinoma; such occurrence might be a mechanism of resistance and might provide new insights on the sensitiveness of different histotypes to systemic therapies. Considering the possibility of a shift from endometrioid to gastrointestinal-type carcinoma may be useful for a correct diagnosis and an appropriate patient management.
KW - Chemotherapy
KW - Endometrial carcinoma
KW - Endometrioid carcinoma
KW - Gastric-type carcinoma
KW - Histotype shift
KW - Mucinous carcinoma
KW - TCGA
KW - Chemotherapy
KW - Endometrial carcinoma
KW - Endometrioid carcinoma
KW - Gastric-type carcinoma
KW - Histotype shift
KW - Mucinous carcinoma
KW - TCGA
UR - http://hdl.handle.net/10807/193182
U2 - 10.1097/PGP.0000000000000843
DO - 10.1097/PGP.0000000000000843
M3 - Article
SN - 0277-1691
VL - 41
SP - 583
EP - 587
JO - International Journal of Gynecological Pathology
JF - International Journal of Gynecological Pathology
ER -