Dedifferentiated Endometrioid Adenocarcinoma Two Cases Report And Review Of The Literature

Objective To analyse the clinical characteristics,diagnosis and management of endometrial dedifferentiated carcinoma by reporting two cases and reviewing the literature.In order to improve the understanding of the disease.Methods Report 2 cases treated in our hospital in detail,analyse and summary EDC cases published in domestic and overseas from 2006 to 2017.Results In the paper,2 cases EDC cases were reported.Case 1 of a56-year-old woman with postmenopausal vaginal bleeding.Specialized examination had no meat-like tissue in the cervical.Uterine curettage pathology revealed cervical canal normal and low differentiation adenocarcinoma.The patient underwent subradical hysterectomy(SRH)with bilateral salpingo-oophorectomy(BSO),pelvic lymphadenectomy,para-aortic lymphadenectomy and probe of sentinel lymphnode development by laparoscopy.Postoperative pathology indicated:(uterus tumor)to differentiate cancer.Highly differentiated endometrial carcinoma with undifferentiated carcinoma.No recurrence was observed for 12 months after operation.Case-2female 77 years old,postmenopausal vaginal irregular bleeding for more than 10 days.Female detection: the cervical mouth has a small amount of dark red blood overflow,the uterus is often large.Diagnosis and treatment of adenocarcinoma of the uterus.Part of the papillary structure.The patient underwent subradical hysterectomy(SRH)with bilateral salpingo-oophorectomy(BSO),the fourth level(renal vein level)retroperitoneal lymphadenectomy and probe of sentinel lymphnode development by laparoscopy.Postoperative pathology showed that the endometrium was differentiated into carcinoma.About 70% of highly differentiated endometrial adenocarcinoma and about 30% undifferentiated carcinomas.No recurrence was observed after 11 months of follow-up.This paper reviewed the report of endometrial differentiation carcinoma,and summarized its clinical features :(1)27 patients were aged between 41 and 83,with an average age of 55;(2)most of the patients(70.3%)had irregular vaginal bleeding or postmenopausal vaginal bleeding,and a small number of patients had vaginal fluid or asymptomatic symptoms.(3)surgical treatment was the mainstay,and postoperative chemoradiotherapy was the mainstay.Most postoperative pathological types were not consistent with preoperative diagnosis,and only 1(3.7%)was consistent.(4)the tumor composition is composed of undifferentiated carcinoma and low-grade endometrial adenocarcinoma.The boundary between the two is clear,and the heterogeneity of undifferentiated components is obvious,and the larger the proportion is,the worse the prognosis is.(5)among the 27 patients,the survival period was as low as 1.75 months,the longest was over 104 months,and 12 patients died,including 1 IB stage,1 case II,5 cases III,5 cases IV.Conclusion Endometrium to clinical differentiation carcinoma is rare,aggressive,prognosis is poor,good hair at menopause,don't be a broad understanding pathologic doctor,postoperative diagnosis and preoperativediagnosis often is not consistent,drawn less for one reason,caused the missed diagnosis or misdiagnosis.The clinical stage and proportion of undifferentiated carcinomas were the main reasons for the prognosis.There is no standard treatment plan for the disease,often with surgery,postoperative radio-chemotherapy as the supplemental treatment.