ENDOMETRIAL ADENOCARCINOMA WITH TROPHOBLASTIC DIFFERENTIATION

Objective. To report a case of stage IIIc poorly differentiated endome trial adenocarcinoma with trophoblastic differentiation and to review previously reported cases. Methods. The clinical course and histopatho logy of the case were reviewed, and a literature search for other repo rted cases was performed. Results. The tumor contained syncytiotrophob last-like giant cells that stained positively for the beta subunit of human chorionic gonadotropin (beta-hCG), and the patient's serum beta- hCG level was elevated (95 mIU/ml), but became undetectable after trea tment. beta-hCG was used as a tumor marker during further therapy. At 16 months' survival, she remains without evidence of disease and with a beta-hCG (level < 5 mIU/ml). Nine other cases of trophoblastic diffe rentiation in gynecologic nontrophoblastic tumors have been reported, five in endometrial carcinomas which we review. Conclusions. Trophobla stic differentiation in gynecologic nontrophoblastic tumors is rare. b eta-hCG may be useful as a tumor marker in these cases. The clinical b ehavior of these tumors has been aggressive, with advanced stages at d iagnosis, early widespread metastases or recurrences and poor patient outcomes. The patient presented in this report, however, remains witho ut evidence of disease 16 months following diagnosis and may be the lo ngest survivor with this tumor reported to date. (C) 1998 Academic Pre ss.