Advanced Stage of Primary Transitional-Cell Carcinoma of the Endometrium: A Case Report and Literature Review

© Copyright 2018, Mary Ann Liebert, Inc. 2018. Background: Primary transitional cell carcinoma (TCC) of the endometrium and endometrial carcinoma with transitional-cell differentiation are rare entities with only 21 cases reported in the international literature. Both conditions are considered subtypes of endometrial carcinoma and, histologically, their papillary patterns and cell characteristics are similar to urothelial carcinoma. Case: A 40-year-old woman presented with vaginal bleeding. A hysteroscopy biopsy enabled the diagnosis of an undifferentiated carcinoma. In addition, computed tomography revealed multiple enlarged lymph nodes as well as severe left hydronephrosis and thrombosis of the left femoroiliac external vein. Surgery enabled removal of the tumor with suboptimal results, and the histologic findings were consistent with a pure TCC of the endometrium with tubarian and nodal metastasis, corresponding to International Federation of Gynaecology and Obstetrics stage IIIC-G3. Because of the tumor's specific histopathologic features, this case highlights the need to consider immunohistochemistry analysis to reach a correct diagnosis and to consider its aggressiveness and clinical behavior, as well as different options for treatment. Conclusions: Only 21 cases of primary TCC of the endometrium and endometrial carcinoma with transitional-cell differentiation have been reported in the international literature. To the current authors' knowledge, this reported case is the only pure TCC in an advanced stage, and this is the most advanced stage of TCC ever reported. (J GYNECOL SURG 34:109)