Morphological Spectrum and Pathological Parameters of Type 2 Endometrial Carcinoma: A Comparison With Type 1 Endometrial Cancers

Atif A Hashmi; Syeda N Iftikhar; Javaria Ali; Fatima Shaheen; Farhath Afroze; Abira Imran

doi:10.7759/cureus.11025

Morphological Spectrum and Pathological Parameters of Type 2 Endometrial Carcinoma: A Comparison With Type 1 Endometrial Cancers

Cureus. 2020 Oct 18;12(10):e11025. doi: 10.7759/cureus.11025.

Authors

Atif A Hashmi¹, Syeda N Iftikhar¹, Javaria Ali¹, Fatima Shaheen², Farhath Afroze³, Abira Imran⁴

Affiliations

¹ Pathology, Liaquat National Hospital and Medical College, Karachi, PAK.
² Internal Medicine, MNR Medical College, Hyderabad, IND.
³ Internal Medicine, Deccan College of Medical Sciences, Hyderabad, IND.
⁴ Statistics, Liaquat National Hospital and Medical College, Karachi, PAK.

Abstract

Introduction Endometrial cancers (ECs) are the most common gynecological malignancies. Based on morphology and pathogenesis, ECs are segregated into type 1 and 2 ECs. Types 1 ECs are those tumors that are estrogen-driven, whereas type 2 ECs are more aggressive and are independent of hormonal status. In the proposed study, we evaluated the clinicopathological parameters of type 2 ECs and its comparison with type 1 ECs. Methods We retrospectively analyzed seven-year data from archives of pathology, Liaquat National Hospital, from January 2013 to December 2019. All patients underwent radical surgeries for diagnosed EC on endometrial biopsy. All specimens were of total abdominal hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and peritoneal sampling, along with pelvic lymphadenectomy. Records regarding tumor type, grade, depth of myometrial invasion, and ovarian, omental, nodal, and parametrial involvement were assessed. Results A total of 129 cases of ECs were included in the study. The mean age of the patients was 57.6 ± 9.3 years. Majority of the cases were type 1 ECs (82.2%). The most common histological type of EC was endometrioid (82.2%) followed by serous carcinoma (10.1%). Most of the tumors were grade 1 (42.6%) and the International Federation of Gynecology and Obstetrics (FIGO) stage I (72.8%). Nodal metastases were present in eight cases (6.2%) and adnexal involvement was present in 12 cases (9.3%). We found a significant association of the type of EC with lymphovascular invasion, nodal metastasis, and adnexal involvement, whereas no significant association of EC type was seen with other clinicopathological characteristics. Conclusions Type 1 EC was the most frequent subtype of EC in our study. On the other hand, type 2 EC was significantly associated with nodal metastasis, lymphovascular invasion, and adnexal involvement, signifying the poor prognostic significance of this group of EC.

Keywords: carcinosarcoma; clear cell carcinoma; endometrial carcinoma; endometrioid carcinoma; serous carcinoma; type 1 endometrial carcinoma; type 2 endometrial carcinoma.