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Case Reports
. 2025 Jan 1;44(1):72-78.
doi: 10.1097/PGP.0000000000001039. Epub 2024 May 29.

POLE-mutated Endometrial "Carcinosarcoma"

Astrid De Boeck  1 , Erik Nohr  1 , Soufiane El-Hallani  2 , Prafull Ghatage  3 , Cheng Han Lee  2 , Martin Köbel  1
Affiliations
Case Reports

POLE-mutated Endometrial "Carcinosarcoma"

Astrid De Boeck et al. Int J Gynecol Pathol. .

Abstract

The molecular subtype classification of endometrial carcinomas has conceptually changed our approach to this disease. However, open questions remain about how to integrate certain histotype diagnoses with the molecular subtype. We report 2 cases with morphologic suspicion for endometrial carcinosarcoma, that still fell short of the essential criteria for diagnosing carcinosarcoma. On subsequent molecular testing pathogenic POLE mutations were detected and a descriptive diagnosis of endometrial endometrioid carcinomas, low-grade with a homologous sarcoma component was rendered. This challenges the existence of POLE-mutated "carcinosarcoma."

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Conflict of interest statement

M.K. is a consultant for HelixBiopharma, outside the scope of this study. The remaining authors declare no conflict of interest.

References

    1. Talhouk A, McConechy MK, Leung S, et al. A clinically applicable molecular-based classification for endometrial cancers. Br J Cancer 2015;113:299–310.
    1. Stelloo E, Nout RA, Osse EM, et al. Improved risk assessment by integrating molecular and clinicopathological factors in early-stage endometrial cancer-combined analysis of the PORTEC cohorts. Clin Cancer Res 2016;22:4215–4224.
    1. Köbel M, Nelson GS. Letter in response to: McAlpine J, Leon-Castillo A, Bosse T. The rise of a novel classification system for endometrial carcinoma; integration of molecular subclasses. J Pathol 2018; 244: 538-549. J Pathol 2018;245:249–250.
    1. Bosse T. The best of both worlds: combining the molecular and traditional (histotype/grade) endometrial cancer classification. AJSP 2022;27:179–186.
    1. Köbel M. Counterpoint: integration of molecular subtype and histotype/grade into one classification system for endometrial carcinoma. AJSP 2022;27:187–197.

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