Abstract

P53-abnormal endometrial carcinomas are high-grade and aggressive tumors which should be treated with chemo-/radiotherapy. In low-grade endometrioid carcinoma (LGEC), abnormal expression of p53 is an exceptional finding and is typically accompanied by patchy p16 positivity and diffuse hormone receptor expression.

Herein, we report a case of LGEC exhibiting both p53 and p16 overexpression, highlighting the diagnostic pitfalls related to such phenotype.

A 60-year-old woman underwent hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy due to a deeply myoinvasive endometrial mass. The tumor showed glandular architecture, low-grade nuclei and glandular differentiation. Focal lymphovascular space invasion and no lymph node metastases were observed. Immunohistochemically, the tumor showed p53 overexpression, p16 block-type positivity, diffuse hormone receptors positivity and retained mismatch repair proteins expression. No POLE mutations were identified. A diagnosis of p53-abnormal LGEC was eventually made.

A glandular neoplasm with p53 and/or p16-overexpression on endometrial biopsy specimens may raise the concern of other entities such as serous carcinoma, HPV-related endocervical adenocarcinoma, and gastric-type adenocarcinoma. An immunohistochemical panel including hormone receptors, p53, p16 and mismatch repair proteins appears necessary for an accurate diagnosis of uterine adenocarcinomas.

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Authors

Susanna Ronchi - Pathology Unit, Department of Oncology, ASST Sette Laghi, Varese, Italy

Eleonora Di Lauro - Pathology Unit, Department of Oncology, ASST Sette Laghi, Varese, Italy

Carla Facco - Pathology Unit, Department of Oncology, ASST Sette Laghi, Varese, Italy

Antonio Raffone - Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy; Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Naples, Italy

Caterina Fulgione - Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Naples, Italy

Jvan Casarin - Gynecology Unit, Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy

Angela Santoro - Pathology Unit, Department of Woman and Child’s Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Pathology Institute, Catholic University of Sacred Heart, Rome, Italy

Damiano Arciuolo - Pathology Unit, Department of Woman and Child’s Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

Giuseppe Angelico - Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, Anatomic Pathology, University of Catania, Catania, Ital

Gian Franco Zannoni - Pathology Unit, Department of Woman and Child’s Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Pathology Institute, Catholic University of Sacred Heart, Rome, Italy

Stefano La Rosa - Pathology Unit, Department of Oncology, ASST Sette Laghi, Varese, Italy; Pathology Unit, Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy

Antonio Travaglino - Pathology Unit, Department of Oncology, ASST Sette Laghi, Varese, Italy; Pathology Unit, Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy

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Copyright (c) 2024 Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology

How to Cite
Ronchi, S., Di Lauro, E., Facco, C., Raffone, A. ., Fulgione, C., Casarin, J., Santoro, A., Arciuolo, D., Angelico, G., Zannoni, G. F., La Rosa, S., & Travaglino, A. (2024). Low-grade endometrial endometrioid carcinoma of the p53-abnormal group: case presentation and diagnostic issues. Pathologica - Journal of the Italian Society of Anatomic Pathology and Diagnostic Cytopathology, 116(5). https://doi.org/10.32074/1591-951X-1044
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