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Undifferentiated endometrial carcinoma, an immunohistochemical study including PD-L1 testing of a series of cases from a single cancer center

International Journal of Gynecologic Pathology Oct 13, 2018

Al-Hussaini M, et al. - Researchers aimed to describe clinical, pathologic, and immunohistochemical characteristics of undifferentiated endometrial carcinoma (UEC) via analyzing 17 cases diagnosed at their center. Patients’ median age was 60 years and the most common presenting symptom was postmenopausal bleeding. Most patients presented with advanced stage and 80% of patients were offered total hysterectomy with bilateral salpingo-oophorectomy as surgical treatment. Sixteen cases showed positivity for one or more of the cytokeratin cocktails, mostly as strong focal staining. Thirteen cases were PAX-8 negative, and in 3 cases, BRG-1/SMARCA4 was lost. Eleven cases were MLH1/PMS2 deficient. For programmed death ligand 1, 10 cases were positive, with positivity in 10%, 20%, and 100% of tumor cells detected in a single case each. Findings thereby suggest that consideration could be given to immunotherapy in the adjuvant setting, particularly with poor response to traditional therapies. As UEC is frequently misdiagnosed, a panel of immunostains is necessary to make the correct diagnosis.

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