ENDOMETRIOID ENDOMETRIAL ADENOCARCINOMA WITH PSAMMOMA BODIES

Since the wide acceptance of serous carcinoma as a distinct subtype of endometrial carcinoma, almost all endometrial carcinomas with psammom a bodies have been classified as such. We describe eight cases of endo metrioid endometrial adenocarcinoma with psammoma bodies and discuss t heir clinicopathologic features. The patients ranged in age from 37 to 79 years. Psammoma bodies were present in the curettage material in t hree and in the hysterectomy specimens in all cases. The tumors were w ell to moderately differentiated with at least focal squamous metaplas ia. Four of eight cases also showed a focal villoglandular architectur e. Inflammation and necrosis were present in all cases, and four had f eatures of pyometra. Deep myometrial invasion was present in six cases . Diffuse lymphatic invasion was present in six, and one showed periva scular lymphocytic infiltrate in the absence of myometrial invasion. T he tumors metastasized to lymph nodes in four of eight cases. One case showed intranodal psammoma bodies in the absence of endosalpingiosis or tumor. Intra-abdominal recurrence was present in only one case and was endometrioid with rare psammoma bodies. All patients are alive, si x with no evidence of disease, one with stable periaortic lymphadenopa thy, and one with progressive disease. This report suggests that endom etrioid endometrial carcinoma may rarely be associated with psammoma b odies, the formation of which is most likely due to inflammation and n ecrosis. It also suggests that endometrioid carcinoma with psammoma bo dies has a higher surgical stage and is more likely to have lymphatic invasion and lymph-node metastases and hence require surgical staging. The pattern of spread appears to be different from uterine papillary serous carcinoma, and the rate of survival is similar to stage-matched endometrioid carcinoma without psammoma bodies.