Female Genital Tract I,Case 3

• Patient is a 69 year-old woman who presents with intermittent vaginal bleeding of 9 months duration.

• Bimanual exam reveals a symmetrically enlarged, non-tender uterus.

Identify the organDescribe the gross findings

Uterus – endometrial cavityA diffuse tumor involves the entire endometrial surface

Tumor

Endometrial cavity

Myometrium

Identify the organIdentify the structuresDescribe the gross findings

A – Endometrial CavityB – Endocervical CanalC - Ectocervix

Endometrial AdenocarcinomaThe surgical specimen consists of the entire uterus, right ovary, and fallopian tube. The uterus is opened along the anterior midline. A polypoid carcinoma (arrow) is present in the upper left corner of the endometrial cavity. Note that the remainder of the cavity is lined by flat, normal epithelium.

Endometrial AdenocarcinomaA close-up view of the endometrial cavity reveals a polypoid carcinoma (arrow). The mucosa lining the remainder of the cavity is normal.

A = Myometrium

Endometrial biopsy - Describe the histologic findingsMicroscopic section of the endometrium reveals an adenocarcinoma. The neoplasm is composed of well differentiated glandswhich are "back to back". Very little stroma exists between the glands. The glands are lined by multilayered, atypical epithelium. Numerous mitoses (arrows) are present.