INTERINSTITUTIONAL SURGICAL PATHOLOGY REVIEW IN GYNECOLOGIC ONCOLOGY-II - ENDOMETRIAL CANCER IN HYSTERECTOMY SPECIMENS

During an 8-year period, 76 post-hysterectomy women with endometrial c ancer were referred to our institution for evaluation or treatment, an d had slides from the hysterectomy specimen sent for review at the req uest of the gynecologic oncologist (interinstitutional consultation). The original diagnosis was retrospectively compared to the review diag nosis and discrepancies were recorded. The most frequent discrepancy, identified in 24 (31.6%) of the 76 cases, involved assessment of myome trial invasion; 19 of these 24 had an original diagnosis of inner or m iddle third myometrial invasion and a review diagnosis of no myometria l invasion. The main reason for this discrepancy was irregularity of t he endomyometrial junction, or, less commonly, extension of tumor into superficial adenomyosis. Additional discrepancies noted in 11 (14.4%) of the 76 cases included: 1) histologic tumor classification in 6 (7. 9%); 2) assessment of angiolymphatic space invasion in 2 (2.6%); 3) id entification of metastatic carcinoma in 1 (1.3%); and 4) change in dia gnosis from adenocarcinoma to complex atypical hyperplasia and atypica l polypoid adenomyoma in 1 each (2.6%). A significant subgroup of pati ents in this series had modifications in diagnosis; the most frequent discrepancy involved overdiagnosis of myometrial invasion, underscorin g the difficulty sometimes encountered in this determination.