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Early Uterine Serous Carcinoma: Clonal Origin of Extrauterine Disease

Baergen, Rebecca N. M.D.; Warren, Cheryl D.; Isacson, Christina M.D.; Ellenson, Lora Hedrick M.D.

International Journal of Gynecological Pathology: July 2001 - Volume 20 - Issue 3 - p 214-219
Original Contributions

Uterine serous carcinoma (USC) is an uncommon but aggressive type of endometrial carcinoma that is frequently associated with extrauterine disease despite minimal or no myometrial invasion. The origin of the extrauterine tumors in this setting remains controversial. The majority of USCs (90%) and endometrial intraepithelial carcinomas (78%), the putative precursor of USC, have p53 mutations, suggesting that p53 alterations occur early in the pathogenesis of USC. To determine if the extrauterine tumors associated with minimally invasive USC and endometrial intraepithelial carcinoma (EIC) represent metastases or multifocal primary tumors, we examined the mutational pattern of the p53 gene in 3 cases of minimally invasive USC and 1 case of EIC and in the corresponding extrauterine tumors associated with each of the cases. In all 4 cases, the primary tumors and the associated extrauterine tumor foci had identical p53 mutations. Our results support the premise that extrauterine serous tumors found in association with EIC or minimally invasive USC represent a unifocal process and thus are early metastases.

From the Department of Pathology, Joan and Sanford I. Weill Medical College of Cornell University and New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York.

Address correspondence and reprint requests to Lora Hedrick Ellenson, M.D., Department of Pathology, New York Presbyterian Hospital-Weill Cornell Center, 525 E. 68th Street, New York, NY 10021.

© 2001 Lippincott Williams & Wilkins, Inc.