Open Access Highly Accessed Case Report

Peritoneal keratin granuloma associated with endometrioid adenocarcinoma of the uterine corpus

Keiichiro Uehara1, Masanori Yasuda1, Takaya Ichimura1, Hiroshi Yamaguchi1, Koji Nagata1, Hidekazu Kayano2, Atsushi Sasaki2, Shin-ichi Murata1 and Michio Shimizu1*

Author affiliations

1 Department of Pathology, Saitama Medical University, International Medical Center, Saitama, Japan

2 Department of Pathology, Saitama Medical University, Saitama, Japan

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Citation and License

Diagnostic Pathology 2011, 6:104  doi:10.1186/1746-1596-6-104

Published: 28 October 2011

Abstract

We present a 69-year-old woman with a chief complaint of postmenopausal bleeding. She was diagnosed as having an endometrioid adenocarcinoma by biopsy, and underwent a total abdominal hysterectomy. At the time of surgery, granulation tissue-like nodules were found on the peritoneal serosa of the uterus. In the intraoperative cytology of peritoneal washing, atypical cells were noted. The intraoperative frozen section of the peritoneal nodule revealed granulation tissue with proliferating mesothelial cells. Microscopic examination of the permanent section showed keratin granulomas without viable adenocarcinoma cells on the serosal surface of the ovaries, fallopian tubes and broad ligaments. Postoperative chemotherapy was administered. She has been alive with no evidence of recurrence for 6 months postoperatively. It should be noted that the prognosis of cases in peritoneal keratin granuloma without viable cancer cells is favorable, and that the histological examination is essential for its diagnosis.

Virtual Slides

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Keywords:
endometrioid adenocarcinoma; peritoneal keratin granuloma; squamous differentiation; uterine corpus