Uncommon Morphologic Types of Endometrial Cancer and Their Mimickers: How Much Does Molecular Classification Improve...

Area of Science:

• Gynecologic Oncology
• Pathology
• Molecular Diagnostics

Background:

• Previous endometrial cancer (EC) staging focused on anatomical spread.
• The 2023 FIGO staging system incorporates clinicopathological and molecular features.
• Accurate histological typing, grading, and molecular profiling are increasingly critical for EC management.

Purpose of the Study:

• To review challenging diagnostic patterns in endometrial cancer histologic subtyping and grading.
• To summarize recent molecular genetic findings and their impact on EC diagnosis and prognosis.
• To discuss the integration of molecular subtypes into clinical practice for EC.

Main Methods:

• Review of challenging histological patterns in EC subtyping and grading.
• Discussion of morphological features differentiating low- and high-grade EC.
• Summary of molecular genetic findings and clinical trial results relevant to EC.

Main Results:

• Identified five challenging EC histological patterns: spindle cell, clear cell, papillary, biphasic, and microglandular.
• Detailed morphological criteria for distinguishing low- and high-grade EC.
• Summarized molecular findings impacting EC diagnosis, prognosis, and treatment.

Conclusions:

• The 2023 FIGO staging emphasizes histological and molecular features for improved EC classification.
• Accurate subtyping and grading, alongside molecular profiling, are essential for personalized EC management.
• Further integration of molecular subtypes into clinical practice is anticipated to refine EC patient care.