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Int J Clin Exp Pathol 2013;6(8):1652-1657

Case Report
Dedifferentiated endometrial cancer: an atypical case diagnosed from cerebellar and
adrenal metastasis: case presentation and review of literature

Roberto Berretta, Tito Silvio Patrelli, Raffaele Faioli, Daniele Mautone, Salvatore Gizzo, Antonio Mezzogiorno, Giovanna Giordano, Alberto Bacchi

Department of Surgical Sciences, University of Parma, Parma, Italy; Department of Woman and Child Health, University of Padua, Padua, Italy;
Department of Public Health, Human Anatomy Unit, Second University of Naples, Napoli, Italy; Department of Pathology and Medicine of
Laboratory, Section of Pathology, University of Parma, Parma, Italy

Received April 26, 2013; Accepted June 29, 2013; Epub July 15, 2013; Published August 1, 2013

Abstract: Dedifferentiated endometrial cancer (DEC) is microscopically characterized by the presence of high-grade areas emerging from low-
grade tumour. DEC is an aggressive tumour even when the dedifferentiated component represents only 20% of the entire neoplasm. A proper
histological diagnosis is essential to define the most appropriate therapeutic approach for these tumors, since they are characterized by a
particularly aggressive trend and by an extremely poor prognosis. We report a single case of DEC associated with dedifferentiated and adrenal
metastasis, for which the patient underwent both abdominal-pelvic and cerebellar surgery. Dedifferentiated carcinoma of the endometrium is a
poorly recognized neoplasm since they have not been clearly defined the histological features discriminating this neoplasm from high-grade
endometrioid adenocarcinoma. Revising existing literature we found 79 described cases of central nervous system secondary involvement and
13 cases where the onset of the disease was characterized by neurological signs and symptoms. We could only find two reported cases of
adrenal metastases originating from endometrial neoplasia but in no case of dedifferentiated endometrial carcinoma previously described has
been reported the concomitant adrenal-cerebellar involvement. (IJCEP1304036).

Keywords: Endometrial cancer, dedifferentiated features, cerebellum metastasis, adrenal metastasis, differential diagnosis

Address correspondence to: Dr. Salvatore Gizzo, Dipartimento della Salute della Donna e del Bambino, U.O.C. di Ginecologia e Ostetricia, Via
Giustiniani 3, 35128 Padova, Italy. Phone: +39 333 5727248; +39 049 8213400; Fax: +39 049 8211785; E-mail: ginecologia_padova@libero.it