Residency Program - Case of the Month

Clinical history:

The patient is a nulligravida 47 year old female with Turner's Syndrome who presented with a 10 month history of irregular vaginal bleeding. Gynecologic history is further significant for menarche at age 15 with premarin and provera; the patient stopped hormone replacement therapy in her twenties with subsequent cessation of menstruation. Physical exam was significant for obesity; pelvic exam did not reveal any abnormalities but was limited. Endometrial biopsy revealed adenocarcinoma and the patient subsequently underwent a total abdominal hysterectomy.

Gross description:

Received fresh was a 34 gm hysterectomy specimen consisting of uterus and bilateral fallopian tubes. The ovaries were not grossly identified. Bivalving of the uterus revealed a polypoid mass involving the posterior lower uterine segment. On cut section the mass involved greater than 50% of the myometrial surface.

Microscopic photographs:

Immunohistochemical Stains:

Figure 1: CK7

Figure 2: EMA

Figure 3: Calretinin

Figure 4: CD10

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