Uterine Serous
Carcinoma (USC)
Epidemiology:
- Older
patients than endometrioid CA
Common sites:
Gross features:
Histologic features:
- resembles
ovarian serous carcinoma
- coarse
fibrovascular stalks
- lining
cells are layered, large, highly malignant-appearing
- macronucleoli
- multinucleated
tumour giant cells
- marked
hyperchromasia
- nucleomegaly
- abnormal
mitotic
figures
- detached
tufts between papillae (useful)
- abundant
mitoses
- psammoma bodies (30%)
- note:
psammoma bodies in post-menopausal women are usually
not associated with malignancy
- propensity
for LVI
and myometrial invasion
- presence
of LVI
is a prognostic factor
- in
situ involvement can be seen in adjacent endometrium
Immunophenotype:
Marker:
|
Sensitivity:
|
Specificity:
|
ER/PR (neg)
|
|
|
P53
|
> 80% (strong)
|
|
MIB-1
(diffuse >
75%, strong)
|
|
|
P16
|
> 90%
(strong)
|
|
Molecular features:
- aneuploid
- c-myc amplification often
- HER-2/neu overexpression
Other features:
- curettage
may only reveal a few tumour cells, because intraendometrial involvement may be small
- propensity
for early metastases and peritoneal involvement
- not
associated with hormone replacement therapy
- not
associated with endometrial hyperplasia
- worse
prognosis
References: