Endometrial Squamous Metaplasia Research Articles

Primary squamous cell carcinoma of the endometrium in elderly women: a report of four cases

Pure squamous cell carcinoma arising in the endometrium represents a rare entity, accounting for <1% of all endometrial malignancies. Limited data about pathogenetics' and behaviours' features are available. Of consequence, there is no consensus about classification and different therapeutic option. Four cases of elderly patients (aged>65years) affected by pure squamous cell carcinoma of the endometrium are presented. Known risk factors for endometrial squamous metaplasia (i.e., pelvic inflammatory disease and cervical stenosis) were observed in two patients. Patients with a disease limited to the uterine corpus had favourable prognosis after surgery±radiotherapy, while one patient with lymph nodes involvement and another who refused staging and/or adjuvant therapy had recurrent disease. Primary squamous cell carcinoma of the endometrium is rare and aggressive occurrence, characteristic of elderly patients. Radical surgery and adjuvant radiotherapy should be administered.

Echogenic Uterine Fluid Collection as an Unusual Presentation of Endometrial Squamous Metaplasia

Background: The optimal management of intrauterine fluid accumulation in postmenopausal women with cervical stenosis is currently debatable. Diagnostic challenge still remains, because of the low accuracy of sonographic histologic prediction. Case: In the case described, an asymptomatic postmenopausal woman was found to have an echogenic endometrial fluid collection on pelvic ultrasound, suspicious for uterine malignancy. Results: After a failed attempt at endometrial sampling secondary to cervical stenosis, the patient underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. The fluid-filled endometrial cavity was found to have extensive benign squamous differentiation. Conclusions: Extensive endometrial squamous metaplasia should be considered as a rare differential diagnosis when postmenopausal women are found to have echogenic intrauterine fluid collections on ultrasound. (J GYNECOL SURG 29:148)

Ichthyosis uteri complicated by poorly differentiated endometrial adenocarcinoma with squamous differentiation

Endometrial squamous metaplasia is a common type of metaplasia. Wide endometrial squamous metaplasia, or ichthyosis uteri, is a rare form of the disease. Malignant transformation based on ichthyosis uteri alone or ichthyosis uteri complicated by other malignant lesions is even rarer. In this study, we report a case of ichthyosis uteri complicated by poorly differentiated endometrial adenocarcinoma. A 74-year-old patient visited the doctor’s office after suffering from irregular and small amounts of vaginal hemorrhage for half a month. Gynecological examination showed a 2-month pregnancy-like uterine enlargement. Histopathological examination confirmed two types of lesions: poorly differentiated endometrioid adenocarcinoma and wide replacement of a large area of endometrium by mature squamous epithelium. Based on previous studies and the current report, the malignant potential of ichthyosis uteri or its simultaneous occurrence with other malignant lesions cannot be completely excluded, although the lesion observed was only considered a benign lesion.

Effects of high-dose isoflavones on rat uterus

Summary Objective To evaluate the effects of high-dose isoflavones on the uterus of castrated adult rats. Methods Adult, ovariectomized virgin rats (n = 40) were treated by gavage during 30 consecutive days with vehicle (propylene glycol, group GCtrl) or different doses of genistein: 42 (group GES42), 125 (GES125), or 250 (GES250) μg/g body weight per day. Animals were killed, weighed, vaginal and uterine samples were taken for cytologic evaluation, and serum levels of 17 β-estradiol and progesterone were determined. The middle third of the uterine horns was dissected, fixed in 10% formaldehyde and processed for paraffin inclusion; 5-μm thick sections were obtained and stained with HE for further histological study under light microscopy. The endometrial morphology and area, number and area of glands, and number of eosinophils in the lamina propria were analyzed. ANOVA and the Tukey-Kramer test were used for statistical analyses. Results Uterine weight, endometrial glandular area, and number of glands and eosinophils were all higher in GES250 > G125 than in the other groups (GES250 > GES125 > GES42 = GCtrl; p Conclusion A short treatment period with high daily doses of isoflavones can promote endometrial squamous metaplasia in ovariectomized rats.

About a Case of Diffuse Endometrial Squamous Metaplasia After Resectoscopic Myomectomy

We report a case of diffuse endometrial squamous metaplasia found after in a resectoscopic myomectomy specimen. A 35-year-old woman underwent an office hysteroscopy that showed a submucosal leiomyoma. After pharmacologic treatment with a GnRH gonadotropin-releasing hormone agonists (GnRHa) leuprolide acetate, the patient underwent a resectoscopic myomectomy. Histologic examination showed fragments of myometrial tissue with the foci of endometrial glands with diffuse features of squamous metaplasia; in part classical, mature type; and in part immature type, and the so-called "morula type." Presence of endometrial squamous metaplasia in the endometrium may produce dramatic histologic changes on biopsies and sometimes it may be difficult to distinguish it from primitive primary carcinomas of nonendometrioid histology, representing therefore, a potential diagnostic pitfall. GnRHa therapy could play a possible role in the onset of squamous metaplasia. So the pathologist and gynecologist must take into account this possible metaplastic change for a correct clinicopathologic assessment and to avoid overtreatment.

Pre-validation study for OECD enhanced test guideline 407 protocol by gavage for 4 weeks using propylthiouracil and tamoxifen

To develop and pre-validate an enhanced protocol for OECD Test Guideline 407, we performed a 28-day repeated-dose toxicity study using the administration of propylthiouracil (PTU) and tamoxifen (TAM) in Sprague–Dawley (SD) rats. Six male and female SD rats were treated orally with PTU in corn oil at the dose of 0, 0.1, 1, or 10 mg/kg per day and TAM at dose of 0, 5, 30 or 200 μg/kg per day for 4 weeks. In the study using PTU, the body weights were reduced from the third week of the study in 10 mg/kg per day group. In clinical biochemistry, the levels of 3,5,3′-triiodothyronine (T3) and thyroxine (T4, 3,5,3′,5′-tetraiodothyrosine) were also significantly decreased in 10 mg/kg per day group. Also, thyroid glands in 10 mg/kg per day group were bigger than those in the control group. In the histopathological examination, diffuse hyperplasia and hypertrophy of thyroid follicular cells were observed in all treatment groups, leading to the reduction of lumen size and papillary enfolding of lining epithelium. In the study using TAM, the body weights were reduced from the first week of the study in 200 μg/kg per day group. Relative testes and epididymes weights were increased and relative right ovary and uterus weights were reduced in 200 μg/kg per day group. Also, in the histopathological finding severe endometrial squamous metaplasia and endometrial gland atrophy and severe follicular cystic change were observed in TAM 200 μg/kg per day-treated group. On the basis of the results, the thyroid hormone levels, gross findings, and histopathological findings may be useful parameters for the detection of the endocrine-related effect of PTU and also reproductive organ weight and histopathological findings may be good parameters to detect the effect of TAM. Therefore, it is concluded that enhanced OECD TG407 might be useful for screening and detecting endocrine disrupters.

Effects found in a one-year oral toxicity study in Sprague-Dawley rats of a novel 5-HT1A receptor partial agonist for the treatment of anxiety in humans.

A potent and selective serotonin (5-HT1A) partial agonist with potential as a human anxiolytic drug was given in oral doses of 0, 5, 15, or 50 mg/kg/day by gavage to Sprague-Dawley rats for 6 or 12 mo. Some animals were allowed 1 mo to recover after each treatment period. The 10-fold increase in dose resulted in a 20-fold increase in drug plasma concentration due to saturable first-pass metabolism. This resulted in disproportionately higher concentrations and greater bioavailability of the 15- and 50-mg/kg/day regimens. Drug exposure was associated with decreased spontaneous activity in the 15- and 50-mg/kg rats. The activity of these rats returned to normal during the recovery period. There were significant (p < 0.05) decreases in mean body weights during the study for 50-mg/kg males, with improvement during the recovery periods. No biologically significant effects were noted in clinical laboratory parameters. Based on organ weight increases and histopathological evaluation, drug-related effects after 6 and 12 mo of treatment were in the pituitary (both sexes) and all treated female reproductive organs. In general, these effects persisted into periods of recovery, except for pituitary hyperplasia, which was not apparent following recovery after treatment for 6 mo. After treatment for 12 mo and the following recovery, there were significant increases in adrenal weights in the 15- and 50-mg/kg/day males with no morphological correlate. There was increased pituitary hyperplasia that persisted through the recovery period in all treated groups in both sexes, but there was no increase in pituitary neoplasms. In treated females, there was also morphologic evidence of persistent diestrus (estrogenic effect) evidenced by endometrial squamous metaplasia, increased corpora lutea, vaginal mucification, and decreased uterine size. The clinical and pathological changes seen with these 2 regimens were considered exaggerated pharmacological effects of the drug on serotonin receptor-rich organs.

Teratogenesis and carcinogenesis in rat offspring after transplacental and transmammary exposure to diethylstilbestrol

Transplacental and transmammary exposure of tat offspring to diethylstilbestrol (DES) was studied in regard to potential teratogenesis and carcinogenesis. Pregnant and/or lactating rats received DES in oil subcutaneously. In females so exposed, abnormal development of the urogenital sinus (hypospadias and urethrovaginal cloaca formation) occurred. In exposed male offspring, hypospadias, phallic hypoplasia, inhibition of growth and descent of testes, as well as abnormalities of Wolffian derivatives, were observed. In 20–40 per cent of DES-exposed female offspring, vaginal adenosis, endometrial squamous metaplasia, and genital malignancy were encountered. Two DES-exposed offspring had a vaginal squamous carcinoma, one had an endometrial adenocarcinoma, and one had an ovarian adenocarcinoma. Vaginal squamous carcinomas may have originated in foci of squamous metaplastic epithelium of vaginal adenosis. None of the control rats developed genital malignancy.

Effect of some oral contraceptive steroids on the development of endometrial squamous metaplasia and cysts in rats

Female rats were injected subcutaneously with 50 μg of norethynodrel plus 2 μg of mestranol per 100 grams of body weight per day for 13 weeks. Controls were treated identically with vehicle alone. These contraceptive steroid treatments caused a significant increase in the incidence of endometrial squamous metaplasia and cyst formation. Treated rats had smaller ovarian and body weights but larger uteri with more luminal fluid than the controls.