Abstract
Background : Secretory adenocarcinoma is a rare neoplasm arising in the endometrium.
Case : A 76-year-old woman with irregular genital bleeding was found in transvaginal ultrasonography to have a 12 mm intrauterine tumor. Endometrial cytology indicated papillary clusters with fibrovascular cores. Tumor cells had vacuolated cytoplasm and round to oval nuclei with small unclear nucleoli. Cytological features were diagnostic of adenocarcinoma (classV). The excised uterus had a 25×15 mm endometrial tumor. Histological findings were consistent with secretory adenocarcinoma of the endometrium. PAS staining with and without diastase digestion showed glycogen accumulation in the cytoplasm. Immunohistochemically, tumor cells were positive for p53, ER, and vimentin (focal) and negative for PgR and HNF-1β.
Conclusion : Similar findings are cytologically observed in clear cell and mucinous adenocarcinoma of the endometrium. Differentiation from secretory adenocarcinoma is aided by 1) papillary clusters with fibrovascular cores resembling well-differentiated endometrioid adenocarcinoma and 2) vacuolated cytoplasm.
