AI Article Synopsis
- The WHO has classified a new type of carcinoma called primary gastric-type carcinoma of the endometrium, which usually has a poor prognosis and needs accurate diagnosis.
- Only 11 cases have been documented, making it crucial to differentiate it from similar tumors like endometrioid adenocarcinoma and various gastro-intestinal carcinomas.
- Diagnostic tools such as immunochemistry and detailed cervical sampling are essential to confirm or rule out this rare entity, particularly to assess differentiation and exclude metastases.
Article Abstract
The latest WHO classification of the female genital tract tumors introduces a new type of carcinoma: the primary gastric-type (or gastro-intestinal type) carcinoma of the endometrium. This type of neoplasm tends to have a poor outcome, making its correct diagnostic important. As little is known about this entity and given its quite challenging diagnosis, we aim to review existing data about it and propose a practical diagnostic approach. There are currently 11 cases published in 8 articles fitting the precise definition of a primary gastric-type carcinoma of the endometrium. Three main differential diagnoses must be excluded before considering this tumor: endometrioid adenocarcinoma with mucinous (Müllerian-type) differentiation, endocervical primary, and gastro-intestinal primary. Morphological aspects of this tumor can be heterogeneous and confusing; in this context, immunochemistry can be helpful to highlight the gastric or intestinal differentiation, but also to eliminate a mucinous endometrioid adenocarcinoma of Müllerian-type, by the constant negativity of estrogen receptors. A metastasis of a primary gastro-intestinal tract carcinoma must also be excluded by clinical, endoscopic and imaging work-up. Finally, an endometrial extension of a primary endocervical gastric-type carcinoma should be ruled out by complete sampling of the cervix. Intestinal type endocervical adenocarcinoma is easier to eliminate since this is an HPV-associated neoplasm.
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| http://dx.doi.org/10.1016/j.prp.2022.154271 | DOI Listing |
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