Atypical endometrial hyperplasia: are there diagnostic difficulties? (Clinical case)
https://doi.org/10.33667/2078-5631-2020-26-46-52
Abstract
The aim of this clinical case is to highlight the importance of differential diagnosing between atypical endometrial hyperplasia (AEH) and endometrial cancer (EC). A 55-year-old woman with AEH had undergone panhysterectomy. Five years later, aching pains appeared in the left abdomen. MRI in the pelvis revealed a solid mass without a clear organ affiliation. The patient underwent laparotomy with removal of the pelvic tumor, resection of the bladder and left ureter and ureterocystostomy on the left. Histopathological examination found an endometrial adenocarcinoma. Immunostaining of primary and subsequent tumors showed a local recurrence of a previously undiagnosed endometrial adenocarcinoma. Primary tumor revealed AEH with foci of adenocarcinoma with signs of dMMR/MSI-H with mosaic reactions to PTEN, PAX2 and negative reaction to ARID1А. Recurrent tumor are moderately differentiated EC with signs of dMMR / MSI-H, a positive reaction to PTEN, a negative reaction to PAX2 and ARID1A was established.
About the Authors
M. S. Sobivchak
Saint Petersburg State University
Russian Federation
Saint Petersburg
Russian Federation
Saint Petersburg
A. E. Protasova
Saint Petersburg State University; North-Western State Medical University n.a. I.I. Mechnikov; National Medical Research Centre n.a. V.A. Almazov; Ava-Peter Co.
Russian Federation
Saint Petersburg
Russian Federation
Saint Petersburg
G. A. Raskin
Saint Petersburg State University; Russian Scientific Centre of Radiology and Surgical Technologies n.a. academician A.M. Granov; Saint Petersburg State Research Institute of Phthisiopulmonology
Russian Federation
Saint Petersburg
Russian Federation
Saint Petersburg
N. I. Tapilskaya
Scientific and Research Institute for Obstetrics and Gynecology n.a. D.O. Ott
Russian Federation
Saint Petersburg
Russian Federation
Saint Petersburg
R. I. Glushakov
Military Medical Academy n.a. S.M. Kirov
Russian Federation
Saint Petersburg
Russian Federation
Saint Petersburg
I. Yu. Kogan
Saint Petersburg State University
Russian Federation
Saint Petersburg
Russian Federation
Saint Petersburg
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For citations:
Sobivchak M.S., Protasova A.E., Raskin G.A., Tapilskaya N.I., Glushakov R.I., Kogan I.Yu. Atypical endometrial hyperplasia: are there diagnostic difficulties? (Clinical case). Medical alphabet. 2020;(26):46-52. (In Russ.) https://doi.org/10.33667/2078-5631-2020-26-46-52
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