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Open Access Highly Accessed Case Report

Endometrial intraepithelial carcinoma in association with polyp: review of eight cases

Masanori Yasuda1*, Tomomi Katoh1, Shinichi Hori1, Kimiyoshi Suzuki2, Kisaku Ohno3, Masanori Maruyama4, Naruaki Matsui5, Sayuri Miyazaki6, Naoki Ogane7 and Yoichi Kameda7

Author affiliations

1 Department of Pathology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan

2 Seiwa Laboratory Company Limited, Saitama, Japan

3 Health Sciences Research Institute East Japan Company Limited, Saitama, Japan

4 Department of Obstetrics and Gynecology, Maruyama Memorial General Hospital, Saitama, Japan

5 Department of Pathology, Tokai University Oiso Hospital, Kanagawa, Japan

6 Division of Pathology, Ebina General Hospital, Kanagawa, Japan

7 Division of Pathology, Kanagawa Cancer Center, Kanagawa, Japan

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Citation and License

Diagnostic Pathology 2013, 8:25  doi:10.1186/1746-1596-8-25

Published: 15 February 2013

Abstract

Background

The uterine endometrial polyp (EMP) has a potential risk of developing malignant tumors especially in postmenopausal women. These malignancies include endometrial intraepithelial carcinoma (EIC).

Patients and methods

Eight patients with EIC in the EMP, who were postmenopausal with ages ranging from 49 to 76 years (av. 62), were cytologically reviewed in comparison with histological findings.

Results

The endometrial cytological findings were summarized as follows: mucous and watery diathesis as a background lacking or with little necrotic inflammatory changes; micropapillary cluster formation; abrupt transition between carcinoma cells and normal cells; nuclear enlargement; high N/C ratio; and single or a few prominent nucleoli. Histologically, one case had EIC alone in the EMP; three cases had EIC with stromal invasion confined to the EMP; and four cases had EIC in the atrophic endometrium in addition to EIC in the EMP. Seven patients have taken a disease-free course after surgical resection, but one patient died 44 months following the initial diagnosis because of the massive tumor extending over her peritoneal cavity.

Conclusions

Endometrial cytology may be helpful for the detection of early endometrial adenocarcinomas with serous features including EIC. Some early stage endometrial adenocarcinomas represented by EIC exceptionally take an aggressive clinical course irrespective of a lack of extrauterine lesions.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1651876760876449 webcite

Keywords:
Endometrial intraepithelial carcinoma (EIC); Endometrial polyp; Cytology