Атипическая гиперплазия эндометрия – диагностические трудности. Есть ли они? (Клинический случай)

Дифференциальная диагностика между атипической гиперплазией эндометрия (АГЭ) и раком эндометрия (РЭ) в некоторых случаях представляет определенные трудности. Описан клинический случай местного рецидива рака эндометрия I стадии с вовлечением органов малого таза через 5 лет после выполнения радикального лечения, при этом при первичном лечении дважды морфологически выставлен диагноз атипической гиперплазии эндометрия: после диагностического выскабливания полости матки и после выполнения пангистерэктомии. При пересмотре препаратов первичной опухоли выявлена атипическая гиперплазия эндометрия с фокусами аденокарциномы с признаками dMMR / MSI-H с мозаичными реакциями на PTEN, PAX2 и негативной реакцией на ARID1А. По данным анализа гистологического материала рецидивной опухоли, установлена умеренно дифференцированная эндометриоидная аденокарцинома эндометрия с признаками dMMR/ MSI-H, позитивной реакцией на PTEN, негативной реакцией на PAX2 и ARID1A.

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