Endometrial adenocarcinoma with diffused/scattered "Intramural" spreads: Report of a case and review of the literature

A case is reported of endometrial adenocarcinoma of the uterus in an 85-yea r-old patient with an unusual spreading pattern. On macroscopic examination , only a tiny exophytic tumor was found in the uterine cavity, while micros copic examination demonstrated a scattered (scirrhous) spread of the carcin oma cells throughout the myometrium. The tumor occupied about half of the u pper uterine corpus. The intramural spread of the tumor could not be seen a t the time of macroscopic examination of the uterine cut surface. The tumor cells were attached closely to the serosal membrane, and metastasis to the left ovary was found. Intraoperative cytology detected malignant cells in the ascites. We present here this unusual type of endometrial carcinoma and review our previous report which dealt with pure "intramural carcinomas of the uterine corpus".