INTRODUCTION: Endometrial hyperplasia represents a diversified set of disorders which has challenged pathologists for decades. Due to its high likelihood of progression to carcinoma, endometrial intraepithelial neoplasia (EIN) demands prompt and specialized intervention. MATERIALS AND METHODS: This 15-month (September 2014 - November 2015) retrospective analysis involved 258 cases of female patients with atypical and non-atypical endometrial hyperplasia investigated and treated at the University Emergency Hospital in Bucharest, Romania. Our purpose was to evaluate the histopathological, immunohistochemical and therapeutical aspects of premalignant endometrial lesions as well as their concurrence with endometrial carcinoma. RESULTS: Our findings indicate that 23% of the women preoperatively diagnosed with atypical hyperplasia were found with endometrial carcinoma on the hysterectomy specimen. Surprisingly, we identified two cases of atypical hyperplasia with focal p53 expression. Mutation of p53 is a late genetic event seen in endometrial carcinoma which does not usually occur in EIN. Interestingly, these cases did not present endometrial carcinoma on the hysterectomy specimen. CONCLUSION: All female patients diagnosed with EIN have an increased risk of developing endometrial carcinoma, as there are no histologic subdivisions or grades of atypical hyperplasia to further stratify risk for malignancy. Therefore, we emphasize the importance of accurate detection of premalignant endometrial lesions and exclusion of a coexisting endometrial carcinoma as mandatory prerequisites for proper medical management.
INTRODUCTION:Endometrial hyperplasia represents a diversified set of disorders which has challenged pathologists for decades. Due to its high likelihood of progression to carcinoma, endometrial intraepithelial neoplasia (EIN) demands prompt and specialized intervention. MATERIALS AND METHODS: This 15-month (September 2014 - November 2015) retrospective analysis involved 258 cases of female patients with atypical and non-atypical endometrial hyperplasia investigated and treated at the University Emergency Hospital in Bucharest, Romania. Our purpose was to evaluate the histopathological, immunohistochemical and therapeutical aspects of premalignant endometrial lesions as well as their concurrence with endometrial carcinoma. RESULTS: Our findings indicate that 23% of the women preoperatively diagnosed with atypical hyperplasia were found with endometrial carcinoma on the hysterectomy specimen. Surprisingly, we identified two cases of atypical hyperplasia with focal p53 expression. Mutation of p53 is a late genetic event seen in endometrial carcinoma which does not usually occur in EIN. Interestingly, these cases did not present endometrial carcinoma on the hysterectomy specimen. CONCLUSION: All female patients diagnosed with EIN have an increased risk of developing endometrial carcinoma, as there are no histologic subdivisions or grades of atypical hyperplasia to further stratify risk for malignancy. Therefore, we emphasize the importance of accurate detection of premalignant endometrial lesions and exclusion of a coexisting endometrial carcinoma as mandatory prerequisites for proper medical management.
Authors: Nicolas M Monte; Kaitlyn A Webster; Donna Neuberg; Gregory R Dressler; George L Mutter Journal: Cancer Res Date: 2010-07-14 Impact factor: 12.701
Authors: X Matias-Guiu; L Catasus; E Bussaglia; H Lagarda; A Garcia; C Pons; J Muñoz; R Argüelles; P Machin; J Prat Journal: Hum Pathol Date: 2001-06 Impact factor: 3.466
Authors: Cyriac Kandoth; Nikolaus Schultz; Andrew D Cherniack; Rehan Akbani; Yuexin Liu; Hui Shen; A Gordon Robertson; Itai Pashtan; Ronglai Shen; Christopher C Benz; Christina Yau; Peter W Laird; Li Ding; Wei Zhang; Gordon B Mills; Raju Kucherlapati; Elaine R Mardis; Douglas A Levine Journal: Nature Date: 2013-05-02 Impact factor: 49.962