Endometrioid Carcinoma Of Endometrium Research Articles

#348 : Primary Broad Ligament Endometrioid Carcinoma – A Case Report of a Rare Entity

Background: Primary broad ligament epithelial malignancies are rare occurrence. Hence, the treatment options are uncertain. Therefore, an accurate diagnosis is warranted to manage this condition. Case report: We present a 61-year-old female with abdominal distension associated with significant weight loss for six months. A computed tomography (CT) scan of the abdomen and pelvis revealed a pelvic mass measuring 10.7 × 14.6 × 13.5 cm with omental caking. Result: An exploratory laparotomy and tumour debulking was performed. Histological examination revealed moderately differentiated endometrioid carcinoma of the broad ligament stage IC and an endometrioid carcinoma of endometrium, stage 1A. She received external beam radiotherapy; brachytherapy followed by adjuvant chemotherapy with a 6 monthly surveillance. Currently, she is healthy with no recurrence at 24 months postoperatively. Conclusion: The rarity of primary broad ligament endometrioid carcinoma may incline clinicians to suspect more common malignancies such as ovarian. However, with an accurate diagnosis, the treatment will allow a better prognosis to the patient.

Expression of chemokine receptor CXCR4 in tumor cells and content of CXCL12+-fibroblasts in endometrioid carcinoma of endometrium.

The expression of the CXCL12chemokine and its receptor CXCR4in the stromal component of the tumor plays an important role in tumor cell migration, proliferation, inhibition of apoptosis and determination of invasive and metastatic potential of malignant neoplasms of various genesis. The significance of CXCL12and CXCR4expression in endometrial tumor cells for cancer progression is not fully understood. To evaluate the content of CXCL12+-fibroblasts and expression of CXCL12and CXCR4in endometrial cancer cells, depending on the tumor stage. Surgical material of 45patients with endometrioid carcinoma of the endometrium (ECE) of the stages I-II and III was studied using morphological and immunohistochemical methods. In ECE of stage I-II CXCR4expression was lower (43.3± 4.2%) while CXCL12expression was higher (33.6± 2.4%) compared with the corresponding indices​​ in ECE of stage III (63.6± 3.5%, 24.5± 1.9%, respectively, p< 0.05). In ECE of stage III, high expression of CXCR4 (> Me) and low CXCL12 (< Me) was observed in 80% of samples; these tumors invaded more than 1/2of the myometrium. There was a positive correlation between the depth of tumor invasion in the myometrium and the presence of metastases and CXCR4expression in tumor cells (R= 0.5and R= 0.4, respectively, p< 0.05) and the negative correlation with the expression of CXCL12 (R= -0.6and R= -0.3, respectively, p< 0.05). In tumors that deeply invaded the myometrium, a high number of the CXCL12+-fibroblasts (> Me) (14.9± 1.3%) was detected. The obtained data reflect the communication of the immunosuppressive factor of the tumor microenvironment, i.e. CXCL12+-fibroblasts and CXCR4expressing tumor cells. We suggest that the aggressiveness of ECE is determined by the combined effect of these two factors.

Importance of promoter methylation of GATA4 and TP53 genes in endometrioid carcinoma of endometrium

Epigenetic changes are considered to be a frequent event during tumor development. Various methylation changes have been identified and show promise as potential cancer biomarkers. The aim of this study was to investigate promoter methylation of GATA4 and TP53 genes in endometrioid carcinoma of endometrium. To search for promoter methylation of GATA4 and TP53 genes we used methylation-specific PCR (MSP) to compare the methylation status of 54 patients with endometrioid carcinoma of endometrium and 18 patients with normal endometrial tissue. In our study MSP revealed GATA4 promoter methylation in 44 of 54 in the carcinoma group (81.5%), and in none of the control group. No methylation was observed in TP53 gene. In conclusion, our study showed that there is significantly higher methylation in GATA4 gene in the endometrial cancer group compared with samples of non-neoplastic endometrium. The finding suggests the importance of hypermethylation of this gene in endometrial carcinogenesis and could have implications for future diagnostic and therapeutic strategies for endometrial cancer based on epigenetic changes.