Residency Program - Case of the Month

Clinical History:

The patient, a 91 year old female, presented with a 6 month history of vaginal bleeding and mild abdominal discomfort. CT scan demonstrated a 2.6 x 3.2 x 5.1 cm mass in the uterus, an 18 mm right pelvic sidewall lymph node, and a 19 mm left adrenal mass. Biopsy of the endometrium performed at an outside institution was interpreted as high-grade undifferentiated malignant neoplasm, favoring undifferentiated uterine sarcoma. A total laparoscopic hysterectomy and bilateral salpingo-oophorectomy was performed.

Gross Description:

Received was a 78.1 gram uterus with cervix and attached bilateral adenexa. Two superficial, broad-based, polypoid masses arising from the anterior and posterior endometrium were identified, measuring 3.0 x 1.5 x 0.7 cm and 3.6 x 2.1 x 1.0 cm, respectively.

Gross Images:

Microscopic Images:

Image 1		Image 2		Image 3
Image 4		Image 5

Immunohistochemistry:

AE1/AE3		p16
Desmin		SMA

P53: Negative
CD10: Negative 

Answer