抄録
Background: The prognostic significance of positive peritoneal cytology in endometrial cancer remains unsettled. We previously classified malignant cell clusters on peritoneal smears into two morphologic types and found that those with irregular edges, so-called “scalloped clusters”, were associated with peritoneal seeding or a poor clinical outcome. We have also reported on the use of postoperative peritoneal washings to investigate residual malignant cells in the peritoneal cavity.
Case: A 56-year-old woman underwent surgery for endometrial cancer (grade 1 endometrioid adenocarcinoma). At operation, positive peritoneal cytology was found without obvious peritoneal seeding, so a tube for cytologic studies was inserted when closing the abdomen. Washings were obtained via the tube at 7 days and 14 days after surgery, and both sets of washings were also positive for malignant cells. All three peritoneal smears showed scalloped clusters. These findings strongly suggested the presence of occult metastasis in the peritoneal cavity that had been overlooked at operation. Despite adjuvant therapy, the patient developed intraperitonal recurrence 8 months after surgery.
Conclusion: Postoperative peritoneal washings and morphologic analysis of positive peritoneal smears are useful to determine the malignant potential of endometrial cancer with positive peritoneal cytology.
