Autopsy and Case Reports
https://www.autopsyandcasereports.org/article/doi/10.4322/acr.2018.041
Autopsy and Case Reports
Article / Clinical Case Report

Primary endometrial large cell neuroendocrine carcinoma with melanocytic differentiation

Lucinda Calheiros Guimarães; Priscila Leandro Garcia; João Badaró Castro Filho; Antonio Carlos Oliveira Meneses

Downloads: 4
Views: 1598

Abstract

High-grade endometrial carcinomas are aggressive neoplasms of difficult histological classification. Neuroendocrine differentiation in endometrial carcinomas is rare. This is the report of an endometrial large cell neuroendocrine carcinoma with foci of melanocytic differentiation in a 75-year-old woman with abnormal post-menopausal uterine bleeding for 2 years. Two initial biopsies were inconclusive. Histopathological examination of the uterus revealed large cell neuroendocrine carcinoma associated with endometrioid carcinoma and foci of melanocytic differentiation, pT3a (FIGO IIIA). There were metastases in the rectum serosa and lungs. After 8 months of diagnosis and surgical treatment, the patient is on chemotherapy and radiotherapy. We highlight the morphological characteristics and criteria that allow the definitive anatomopathological diagnosis, including immunohistochemical markers used to identify the cell types present in this unprecedented association.

Keywords

Endometrium, Carcinoma, Neuroendocrine, Carcinoma, Large Cell, Melanocytes, Immunohistochemistry

References

Kumar V, Abbas AK, Aster JC, editors. Robbins and Cotran pathologic basis of disease. 9th ed. Philadelphia: Elsevier/Saunders; 2015.

Kurman RJ, Ellenson LH, Ronnett BM, editors. Blaunstein’s pathology of the female genital tract. 6th ed. New York: Springer; 2011. [https://doi.org/10.1007/978-1-4419-0489-8].

Instituto Nacional de Câncer José Alencar Gomes da Silva. Coordenação de Prevenção e Vigilância. Estimativa 2018: incidência de câncer no Brasil [Internet]. Rio de Janeiro: INCA; 2017 [cited 2018 May 17]. Available from: http://www.inca.gov.br/estimativa/2018/

Howitt BE, Kelly P, McCluggage WG. Pathology of neuroendocrine tumours of the female genital tract. Curr Oncol Rep. 2017;19(9):59. [https://doi.org/10.1007/s11912-017-0617-2]. [PMID:28735441]

Pocrnich CE, Ramalingam P, Euscher ED, Malpica A. Neuroendocrine carcinoma of the endometrium: a clinicopathologic study of 25 cases. Am J Surg Pathol. 2016;40(5):577-86. [https://doi.org/10.1097/PAS.0000000000000633]. [PMID:26945341]

Matsumoto H, Nasu K, Kai K, Nishida M, Narahara H, Nishida H. Combined large‐cell neuroendocrine carcinoma and endometrioid adenocarcinoma of the endometrium: a case report and survey of related literature. J Obstet Gynaecol Res. 2016;42(2):206-10. [https://doi.org/10.1111/jog.12881]. [PMID:26807962]

Mulvany NJ, Allen DG. Combined large cell neuroendocrine and endometrioid carcinoma of the endometrium. Int J Gynecol Pathol. 2008;27(1):49-57. [https://doi.org/10.1097/pgp.0b013e31806219c5]. [PMID:18156975]

Amant F, Moerman P, Davel GH, et al. Uterine carcinosarcoma with melanocytic differentiation. Int J Gynecol Pathol. 2001;20(2):186-90. [https://doi.org/10.1097/00004347-200104000-00012]. [PMID:11293166]

Kajo K, Zubor P, Spacek J, Ryska A. Carcinosarcoma of the uterus with melanocytic differentiation. Pathol Res Pract. 2007;203(10):753-8. [https://doi.org/10.1016/j.prp.2007.05.010]. [PMID:17656038]

Ishida M, Kagotani A, Yoshida K, Iwai M, Okabe H. Endometrioid adenocarcinoma concurrent with a blue nevus of the endometrium and uterine cervix: a case report. Oncol Lett. 2013;6(5):1219-21. [https://doi.org/10.3892/ol.2013.1575]. [PMID:24179498]

Shintaku M, Tsuta K, Matsumoto T. Blue nevus of the endometrium. Int J Gynecol Pathol. 2003;22(3):294-6. [https://doi.org/10.1097/01.PGP.0000070847.25718.DE]. [PMID:12819399]

Soslow RA. High‐grade endometrial carcinomas: strategies for typing. Histopathology. 2013;62(1):89-110. [https://doi.org/10.1111/his.12029]. [PMID:23240672]

Tu YA, Chen YL, Lin MC, Chen CA, Cheng WF. Large cell neuroendocrine carcinoma of the endometrium: a case report and literature review. Taiwan J Obstet Gynecol. 2018;57(1):144-9. [https://doi.org/10.1016/j.tjog.2017.12.025]. [PMID:29458887]

Deodhar KK, Suryawanshi P, Menon S, Kerkar RA, Menon H. Large cell neuroendocrine carcinoma of the endometrium: an extremely uncommon diagnosis, but worth the efforts. J Cancer Res Ther. 2011;7(2):211-3. [https://doi.org/10.4103/0973-1482.82942]. [PMID:21768718]

Posligua L, Malpica A, Liu J, Brown J, Deavers MT. Combined large cell neuroendocrine carcinoma and papillary serous carcinoma of the endometrium with pagetoid spread. Arch Pathol Lab Med. 2008;132(11):1821-4. [PMID:18976022]

Terada T. Large cell neuroendocrine carcinoma with sarcomatous changes of the endometrium: a case report with immunohistochemical studies and molecular genetic study of KIT and PDGFRA. Pathol Res Pract. 2010;206(6):420-5. [https://doi.org/10.1016/j.prp.2009.12.008]. [PMID:20189318]

Kurman RJ, Carcangiu ML, Herrington CS, et al., editors. WHO classification of tumours of female reproductive organs. 4th ed. Lyon: IARC; 2014.

Nguyen MLT, Han L, Minors AM, et al. Rare large cell neuroendocrine tumor of the endometrium: a case report and review of the literature. Int J Surg Case Rep. 2013;4(8):651-5. [https://doi.org/10.1016/j.ijscr.2013.04.027]. [PMID:23792474]

Gould VE, Memoli VA, Dardi LE, Sobel HJ, Somers SC, Johannessen JV. Neuroendocrine carcinomas with multiple immunoreactive peptides and melanin production. Ultrastruct Pathol. 1981;2(3):199-217. [https://doi.org/10.3109/01913128109048304]. [PMID:6117142]

 

 

 


Publication date:
09/26/2018

5bab7c5b0e8825350cffacb9 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections