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Department of Pathology and Laboratory Medicine

Department of Pathology and Laboratory Medicine

Residency Program - Case of the Month

February 2014 - Presented by Christina Di Loreto, M.D.


Clinical History:

The patient, a 91 year old female, presented with a 6 month history of vaginal bleeding and mild abdominal discomfort. CT scan demonstrated a 2.6 x 3.2 x 5.1 cm mass in the uterus, an 18 mm right pelvic sidewall lymph node, and a 19 mm left adrenal mass. Biopsy of the endometrium performed at an outside institution was interpreted as high-grade undifferentiated malignant neoplasm, favoring undifferentiated uterine sarcoma. A total laparoscopic hysterectomy and bilateral salpingo-oophorectomy was performed.


Gross Description:

Received was a 78.1 gram uterus with cervix and attached bilateral adenexa. Two superficial, broad-based, polypoid masses arising from the anterior and posterior endometrium were identified, measuring 3.0 x 1.5 x 0.7 cm and 3.6 x 2.1 x 1.0 cm, respectively.


Gross Images:

Gross 1   Gross 2


Microscopic Images:

Image 1   Image 2   Image 3

Image 1

 

Image 2

 

Image 3

         
Image 4   Image 5    
Image 4   Image 5    


Immunohistochemistry:

AE1/AE3   p16
AE1/AE3   p16
     
Desmin   SMA
Desmin   SMA

P53: Negative
CD10: Negative 


Answer