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Poorly differentiated endometrial sarcoma with clear cell features.

M Fukunaga1

  • 1Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan. maasafu@jikei.ac.jp

APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica
|March 14, 2002
PubMed
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This case study presents a rare poorly differentiated endometrial sarcoma with clear cell features in a 46-year-old female. Pathologists must recognize this distinct entity to avoid misdiagnosis with other clear cell neoplasms.

Area of Science:

  • Gynecologic Pathology
  • Oncology
  • Surgical Pathology

Background:

  • Endometrial sarcomas are rare uterine malignancies.
  • Clear cell features can occur in various neoplasms, necessitating careful differential diagnosis.

Observation:

  • A 46-year-old female presented with a large, transmural uterine fundic tumor.
  • Histological examination revealed a poorly differentiated sarcoma with clear cell morphology, infiltrative growth, vascular invasion, atypia, high mitotic activity, and necrosis.

Findings:

  • Immunohistochemistry was positive for vimentin and negative for cytokeratin (CAM5.2), epithelial membrane antigen, desmin, muscle actin, and hormone receptors.
  • Electron microscopy identified dilated mitochondria and lipid droplets as the source of clear cytoplasm.
  • Flow cytometry demonstrated a diploid DNA content.

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Implications:

  • This case highlights a rare variant of endometrial sarcoma with distinctive clear cell features.
  • Awareness among pathologists is crucial to differentiate this entity from other clear cell-containing tumors, ensuring accurate diagnosis and appropriate patient management.