Secretory adenocarcinoma of the endometrium.
Secretory adenocarcinomas of the endometrium are uncommon tumors distinct from clear cell carcinomas. We reviewed nine cases that included the original endometrial curettings and the specimens of uteri with both adnexa [total abdominal hysterectomy-bilateral salpingo-oophorectomy (TAH-BSO)]. The patients' ages ranged from 36 to 79 years (with an average of 55 years). Six women were postmenopausal, and most complained of vaginal bleeding. Two patients were nulliparous and the others had one to four children. Four patients were obese, of whom one was diabetic and hypertensive. Eight tumors were of grade I and one was grade II. The histologic pattern was comparable to that of secretory endometrium, days 17 to 22, and the glands were positive with periodic acid-Schiff (whether predigested or not); they were partly positive with alcian blue and negative with Best Carmine. The carcinoma in one case was positive for carcinoembryonic antigen; all cases were negative with alpha-fetoprotein. Six patients were staged as IA and three as IB. One 47-year-old patient had a concurrent endometrioid adenocarcinoma (grade II) of the right ovary with squamous, clear cell, and mucinous components. Three cases had no tumour penetration of the myometrium while in the others penetration varied from 5 to 70%. One patient received intracavitary radium prior to TAH-BSO and two had postoperative radiation. All patients are alive 11 to 113 months following surgery. Secretory adenocarcinoma of the endometrium should be separated from clear cell carcinoma, as it has the pattern of secretory endometrium day 17 to 22, is very well differentiated, and has a relatively good prognosis.
D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D009626:Terminology as Topic; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*