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J Cancer 2012; 3:14-18. doi:10.7150/jca.3.14

Case Report

Endometrioid Adenocarcinoma with High-Grade Transformation with Serous and Choriocarcinomatous Differentiation - A Case Report

Senn Wakahashi¹, Tamotsu Sudo^1,2,✉, Eriko Nakagawa¹, Sayaka Ueno¹, Miho Muraji¹, Seiji Kanayama¹, Hiroe Itami³, Fumi Kawakami³, Takashi Yamada¹, Satoshi Yamaguchi¹, Kiyoshi Fujiwara¹, Hironobu Nishikawa⁴, Ryuichiro Nishimura¹, Chiho Ohbayashi³

1. Department of Gynecologic Oncology, Hyogo Cancer Center, 13-70 Kita-Oji, Akashi, Hyogo 673-8558, Japan.
2. Section of Translational Research, Hyogo Cancer Center, 13-70 Kita-Oji, Akashi, Hyogo 673-8558, Japan.
3. Department of Diagnostic Pathology, Hyogo Cancer Center, 13-70 Kita-Oji, Akashi, Hyogo 673-8558, Japan.
4. Department of Surgery, Mitsu Municipal Hospital, 1666 Nakashima, Mitsu, Tatsuno, Hyogo 671-1311, Japan.

Abstract

A choriocarcinoma component with a malignant tumor is relatively rare. We present a case of an 85-year-old woman with mixed carcinoma, which was endometrioid adenocarcinoma with squamous differentiation, choriocarcinoma and a disseminated peritoneal nodule, which was papillary serous adenocarcinoma. The patient received surgery and conservative treatment. Twenty weeks after surgery, a recurring tumor appeared at the Douglas pouch. Histology showed that the recurring tumor was poorly differentiated carcinoma that was very different from the primary tumor. This case represents an unusual uterine corpus cancer with high-grade transformation with serous and choriocarcinomatous differentiation. This case also demonstrates the capacity of tumor cells to differentiate into divergent elements.

Keywords: hCG, choriocarcinoma, endometrial cancer, squamous cell carcinoma, trophoblastic tumor.