Dedifferentiated endometrioid adenocarcinoma of the uterus: A case series and review of literature

• Main Authors: C. Goh, B.L. Farah, W.Y. Ho, S.L. Wong, C.H.R. Goh, S.H. Chew, R. Nadarajah, Y.K. Lim, T.H. Ho
• Format: Article
• Language: English
• Published: Elsevier 2020-05-01
• Series: Gynecologic Oncology Reports
• Subjects: Dedifferentiated endometrioid adenocarcinoma; Endometrial cancer; Mismatched repair gene; Immunotherapy
• Online Access: http://www.sciencedirect.com/science/article/pii/S2352578920300047

Introduction Dedifferentiated endometrioid adenocarcinoma (DEAC) was first described in 2007. However, it has only been recognised as a distinct subtype of endometrioid adenocarcinoma in the last 1–2 years. DEAC is a more aggressive histological subtype and carries a poorer prognosis. Patients with DEAC tend to present with advanced disease compared the other endometrioid adenocarcinomas. Methodology The study is a retrospective review of patients with DEAC diagnosed in two institutions in Singapore between January 2012 and October 2017. Results 7 patients were diagnosed with DEAC. The mean age was 56.4 years. All patients presented with either abnormal uterine bleeding or post menopausal bleeding. Out of the 7 patients, one was diagnosed with Stage 2 disease, 5 were diagnosed with Stage 3 disease and 1 was diagnosed with Stage 4 disease. One patient had neoadjuvant chemotherapy, followed by surgery, and completion chemotherapy post surgery. The other 6 patients (87.5%) underwent primary debulking surgery. Out of these 6 patients, 5 patients had adjuvant chemotherapy post surgery and one patient had both adjuvant chemotherapy and radiotherapy. Lymphovascular invasion was found in 71.4% of the cases. Conclusion DEAC is a more aggressive histological subtype of endometrioid adenocarcinomas. Better awareness of this condition can lead to proper diagnosis and treatment.