Unmasking Mixed Endometrial Carcinoma: A Case Report of Diagnostic Complexity.
Neha Yadav, Sanjay Kumar Kannaujia, Shilpi Srivastava et al.
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Case in brief
A 61-year-old postmenopausal woman presented with abnormal uterine bleeding, intermittent lower abdominal pain, and mild pelvic discomfort. Ultrasound showed a thickened, irregular endometrium with a heterogeneous mass. Endometrial biopsy and immunohistochemistry supported mixed endometrial carcinoma. Hysterectomy revealed a friable, irregular endometrial growth with papillary excrescences infiltrating the myometrium. Microscopy demonstrated coexisting endometrioid and serous components, confirming the diagnosis.
What made this case unusual
The diagnostic complexity lay in identifying two distinct histological components—endometrioid and serous—in the same carcinoma, with the serous component representing a high-grade pattern.
Diagnostic / clinical pearl
When evaluating endometrial carcinoma, assess for distinct histological components; biopsy and immunohistochemistry can support recognition of a mixed tumour, with hysterectomy specimens providing further morphological confirmation.