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Case Reports
. 2018 Sep 26;8(4):e2018041.
doi: 10.4322/acr.2018.041. eCollection 2018 Oct-Dec.

Primary endometrial large cell neuroendocrine carcinoma with melanocytic differentiation

Lucinda Calheiros Guimarães  1 , Priscila Leandro Garcia  1 , João Badaró Castro  1 , Antonio Carlos Oliveira Meneses  1
Affiliations
Case Reports

Primary endometrial large cell neuroendocrine carcinoma with melanocytic differentiation

Lucinda Calheiros Guimarães et al. Autops Case Rep. .

Abstract

High-grade endometrial carcinomas are aggressive neoplasms of difficult histological classification. Neuroendocrine differentiation in endometrial carcinomas is rare. This is the report of an endometrial large cell neuroendocrine carcinoma with foci of melanocytic differentiation in a 75-year-old woman with abnormal post-menopausal uterine bleeding for 2 years. Two initial biopsies were inconclusive. Histopathological examination of the uterus revealed large cell neuroendocrine carcinoma associated with endometrioid carcinoma and foci of melanocytic differentiation, pT3a (FIGO IIIA). There were metastases in the rectum serosa and lungs. After 8 months of diagnosis and surgical treatment, the patient is on chemotherapy and radiotherapy. We highlight the morphological characteristics and criteria that allow the definitive anatomopathological diagnosis, including immunohistochemical markers used to identify the cell types present in this unprecedented association.

Keywords: Carcinoma, Large Cell; Carcinoma, Neuroendocrine; Endometrium; Immunohistochemistry; Melanocytes.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1. Gross features: a pedunculated polypoid endometrial mass with interspersed black and hemorrhagic areas.
Figure 2
Figure 2. Photomicrograph of the tumor showing in A – nesting pattern (HE, 20x); B – Large cells with bulky and bizarre nuclei (HE, 40x); C – Neoplastic cells show strong cytoplasmic expression of synaptophysin (40x); D – Melanocytic differentiation: cells with granular brown pigment (HE, 40x).
Figure 3
Figure 3. Photomicrograph of the tumor showing expression of melan-A in part of the neoplastic cells (40x).
See this image and copyright information in PMC

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