Endometrial serous carcinoma: its molecular characteristics and histology-specific treatment strategies

Abstract

Endometrial cancer is the fourth most common malignancy in women, with most cases being classified as early stage endometrioid tumors that carry a favorable prognosis. The endometrial serous histological subtype (ESC), however, while only accounting for 10% of all endometrial cancers is responsible for a disproportionate number of deaths. Unlike the estrogen-dependent, well differentiated endometrioid tumors, which are commonly associated with a younger age of onset, ESCs are estrogen-independent and tend to present at an advanced stage and in older women. Treatment for ESC entails aggressive surgery and multimodal adjuvant therapy. In this review, we describe the clinical behavior, molecular aspects, and treatment strategies for ESC.

Figure 1

Endometrial serous carcinoma is characterized by high-grade cytological atypia in cells that do not share a common apical border. A papillary architecture is common.

Figure 2

Endometrioid adenocarcinoma, grade 1. The glandular component is a caricature of proliferative phase glands, with stratification and shared luminal border to the neoplastic cells.