Have you seen this newly recognized WHO tumor entity? I’m delighted to share this comprehensive review just published
@Human_Pathology (PMID: 41475433), beautifully written by Gahie, Hui-Min, and my colleagues
@BrownPathology
Endometrial gastric (gastrointestinal) -type mucinous adenocarcinoma (EGMA) is a rare histologic subtype of endometrial carcinoma that has recently included as a new WHO entity and is now recognized by the 2023 FIGO staging system as an aggressive histologic subtype. Previously, these tumors often overlapped diagnostically with endometrioid carcinomas showing mucinous differentiation; however, EGMA is now clearly established as a distinct clinicopathologic entity with more aggressive behavior.
Morphologically, tumor cells show gastric and/or intestinal differentiation with variable cytologic atypia.
Immunohistochemically, ER and PR are negative or only focally positive (<5%), while tumor cells express gastrointestinal markers, including CDX2, MUC6, HIK1083, and SATB2. Clinically, EGMA is associated with a higher likelihood of deep myometrial invasion, lymphovascular invasion, and lymph node metastasis.
At present, complete surgical resection - including hysterectomy with bilateral salpingo-oophorectomy, tumor debulking, with or without pelvic/paraaortic lymph node dissection -appears to be the most effective primary treatment. Adjuvant chemotherapy is also likely beneficial, particularly for higher-stage disease.
This review emphasizes the importance of judicious use of immunohistochemistry, careful morphologic evaluation, and close correlation with clinical history to accurately diagnose EGMA and distinguish it from important mimics.
🔗 Full article is available at the following link:
sciencedirect.com/science/ar…