%0 Journal Article
%T HPV11 Positive Endometrioid Carcinoma of the Endometrium with Signet-Ring Cells: Diagnostic Criteria and Review of the Literature
%A Teresa Pusiol
%J Case Reports in Pathology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/380571
%X The presence of signet-ring cells in an endometrial adenocarcinoma is extremely uncommon and it is always necessary to rule out a metastatic neoplasm. We report a FIGO grade 2 endometrial carcinoma with a signet-ring cell component found in the curettage performed to a 53-year-old woman. The neoplastic proliferation was also found in the endometrium of the radical hysterectomy with bilateral salpingo-oophorectomy and pelvic and para-aortic lymphadenectomy. The uterine neoplasm invaded less than one-half of the myometrium (FIGO stage I B). Alcian blue showed the presence of mucin in the signet-ring cells. The patient was alive and without evidence of recurrence 14 months after surgery. Polymerase chain reaction method from paraffin-embedded tissue revealed the presence of human papilloma virus type 11. We have discussed the differential diagnosis of this kind of neoplasm and we have reviewed the literature on signet-ring cell carcinoma of the endometrium. 1. Introduction Signet-ring cell (SRC) carcinoma is defined as a tumor composed predominantly or exclusively of SRCs, characterized by a central, optically clear, globoid droplet of cytoplasmic mucin with an eccentrically placed nucleus. SRCs are generally rare in primary adenocarcinomas of the female genital tract. To the best of our knowledge primary carcinoma of the endometrium with SRCs has only been observed in four previous cases [1¨C3] (Table 1). In fact primary pure endometrial SRCs adenocarcinomas of the genital tract are extremely rare, while more often they may be seen admixed with other more conventional types. In this paper we report a new case of endometrial adenocarcinoma (EA) with SRCs component. We have reviewed the literature in order to emphasize the histological criteria in the diagnosis of this very unusual malignancy. Table 1: Endometrial adenocarcinoma with signet-ring cells: review of the literature. 2. Materials and Methods A 53-year-old multiparous (gravida 4, para 4) woman was referred to the Department of Obstetrics and Gynecology for persistent abnormal vaginal bleeding of three-month duration. An endometrial curettage was performed. An extensive search for an extrapelvic primary cancer was undertaken, but abdominopelvic computed tomography (CT), mammography, cystoscopy, esophagogastroduodenoscopy, and colonoscopy revealed no evidence of malignancy. The patient underwent a radical hysterectomy with bilateral salpingo-oophorectomy and pelvic and para-aortic lymph node dissection. The patient provided written informed consent to perform the study. Tissue specimens were fixed in
%U http://www.hindawi.com/journals/cripa/2014/380571/