A RARE CASE OF SEROUS CARCINOMA OF THE UTERINE CORPUS THAT ARISES IN POLYP

Ana Kocevska; Emil Bajalski; Dimitar Georgiev; Bashkim Ismaili; Kristina Skeparovska; Shenol Tahir; Aleksandar Nakov

Ana Kocevska Specialized Hospital for Gynecology and Obstetrics “Mother Teresa” – Skopje, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, R. North Macedonia
Emil Bajalski Specialized Hospital for Gynecology and Obstetrics “Mother Teresa” – Skopje, R.North Macedonia
Dimitar Georgiev Specialized Hospital for Gynecology and Obstetrics “Mother Teresa” – Skopje, R.North Macedonia
Bashkim Ismaili Specialized Hospital for Gynecology and Obstetrics “Mother Teresa” – Skopje, R.North Macedonia
Kristina Skeparovska Specialized Hospital for Gynecology and Obstetrics “Mother Teresa” – Skopje, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, R. North Macedonia
Shenol Tahir University Clinic for Surgical Diseases "St. Naum Ohridski" - Skopje, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
Aleksandar Nakov Specialized Hospital for Gynecology and Obstetrics “Mother Teresa” – Skopje, R.North Macedonia

Abstract

Endometrial polyps (EPs) are common pathological findings and their prevalence range is between 16% to 34% depending on characteristics of the examined population and detecting methods. Clinically, these lesions cause thickening of the endometrium and abnormal uterine bleeding. Asymptomatic EPs can be detected by routine ultrasound examination or infertility investigations. Most EPs are benign. Their malignant potential is highest in postmenopausal women with uterine bleeding (2.3%). Serous carcinoma is the prototype of type-II endometrial cancer (nonendometrioid) and accounts for <10% of all endometrial carcinomas. It is a very aggressive tumor, unrelated to estrogen stimulation, arising occasionally in endometrial polyps or from precancerous lesions developing in atrophic endometrium that mainly occur in older women. We present a case of 72-years-old patient with uterine bleeding, with thick and heterogenous endometrium detected on ultrasound. Fractionated explorative curretage was performed and serous carcinoma that arises in polyp was diagnosed. After operative treatment, histopathological analysis of the operative material showed stage II of the disease.

Keywords: endometrial polyps, abnormal uterine bleeding, serous carcinoma, endometrial thickening.

https://doi.org/10.55302/JMS2251044k

References

1. Hileeto WF, Fadare O, Martel M, Zheng W. Age dependent association of endometrial polyps with increased risk of cancer involvement. World J Surg Oncol 2005;3(1):8.
2. Lieng M, Istre O, Qvigstad E. Treatment of endometrial polyps: a systematic review. Acta Obstet Gynecol Scand 2010;89:992-1002.
3. Стојовски М. Бенигни лезии на горен дел од генитален тракт. Во: Антовска В. Стојовски М, Гинекологијa, учебник наменет за студенти по медицина, специјализанти по гинекологија и акушерство и специјалисти гинеколози-акушери. Скопје; 2016, стр: 771-84.
4. Incidence, Mortality and Prevalence by cancer site. Globocan. International Agency for research on Cancer. WHO. Достапно на [https://gco.iarc.fr/today/data/factsheets/populations/807-north-macedonia-fact-sheets.pdf]. Accessed on 01.04.2022.
5. Стојовски М. Ендометријален канцер, Во: Антовска В. Стојовски М, Гинекологијa, учебник наменет за студенти по медицина, специјализанти по гинекологија и акушерство и специјалисти гинеколози-акушери. Скопје; 2016, стр: 796-805.
6. Clement PB, Young RH . Non-endometrioid carcinomas of the uterine corpus: a review of their pathology with emphasis on recent advances and problematic aspects. Adv Anat Pathol 2004;11:117–142.
7. Matthews RP, Hutchinson-Colas J, Maiman M et al. Papillary serous and clear cell type lead to poor prognosis of endometrial carcinoma in black women. Gynecol Oncol 1997;65:206–212.
8. Milosevic J, Dzordzevic B, Tasic M. Uticaj menopauzalnog statusa na ucestalost i patohistoloske karakteristike hiperplazije I carcinoma endometrijuma kod bolesnica sa nenormalnim uterusnim krvarenjem. Acta Medica Medianae 2008;47(2):33-7.
9. Fernandez-Parra J, Rodriguez Oliver A, Lopez Criado S, et al. Hysteroscopic evaluation of endometrial polyps. Int J Gynaecol Obstet 2006;95(2): 144-8.
10. Ferazzi E, Zupi E, Leone FP, et al. How often are endometrial polyps malignant in asymptomatic postmenopausal women? A multicenter study. Am J Obstet Gynecol 2009 Mar;200(3):235.e1-6.
11. Antunes Jr A, Costa-Paiva L, Arthuso M, et al. Endometrial polyps in pre- and postmenopausal women: Factors associated with malignancy. Maturitas 2007;57:415-21.
12. Tavassoli FA, Devilee P, eds. World Health Organization classification of tumours. Pathology and genetics of tumours of the breast and female genital organs. Lyon: IARC Press, 2003: 221-32.