ABSTRACT
Immunohistochemical expression of bcl-2, p53, PR and ER in cases with endometrial carcinomas arrayed on a tissue microarray (TMA) was tested and correlated with clinicopathologic features, overall survival (OS), cancer-related survival (CRS) and disease-free survival (DFS). Seventy-seven patients with endometrial cancer were reviewed. Slides were evaluated by two pathologists blinded to patient clinical characteristics and survival data. Mean age of patients was 62.5 years (range 35-80), median follow up 60 months (range 9-120). Seventy-nine percent of patients were FIGO Stage I; 39% of the cases showed bcl-2 cytoplasmic staining and its expression was significantly correlated with low-grade tumor differentiation and age < or = 60 years. Nuclear p53 overexpression was detected in 23.4% of the cases and was significantly correlated with advanced stages (IIB-IV), non-endometrioid histology, nodal metastasis and advanced age (> 60 years). PR and ER were positive in 63.6% and 30% of the cases, respectively. Analysis of p53 overexpression and bcl-2 expression in relationship with PR and ER status showed a direct correlation between bcl-2 expression and PR positivity (p = 0.001). In a multivariate analysis FIGO staging was the only clinicopathologic parameter independently correlated with DFS. In conclusion p53 overexpression was directly associated with unfavorable clinicopathologic factors such as advanced stage, histologic subtype, advanced patient age and nodal metastasis. Bcl-2 expression was related with younger age, favorable grade and PR expression by tumor cells. Patient survival was not related to the tested biomarkers.
Subject(s)
Adenocarcinoma/physiopathology , Endometrial Neoplasms/physiopathology , Proto-Oncogene Proteins c-bcl-2/metabolism , Receptors, Progesterone/metabolism , Tumor Suppressor Protein p53/metabolism , Adenocarcinoma/immunology , Adult , Aged , Aged, 80 and over , Cohort Studies , Disease-Free Survival , Endometrial Neoplasms/immunology , Female , Humans , Middle Aged , Neoplasm Staging , Protein Array Analysis , Receptors, Estrogen/metabolismABSTRACT
Solitary carcinomatous metastases to the spleen are rare. The reports of such cases in the literature usually concern late stages of the disease, with generalized carcinomatosis and metastatic foci in several other organs. Primary tumors that most often metastasize to the spleen are carcinomata of the breast, lung and ovaries, as well as malignant melanomata. Less often, carcinomata of the stomach, large bowel and kidneys are reported to implicate the organ with metastatic disease. The presence of solitary splenic metastasis of endometrial origin however, is extremely rare. We present a case of a 53-year-old female patient who ten years after hysterectomy due to the presence of endometrial carcinoma developed a metastatic focus to the spleen. This focus was diagnosed on the grounds of histology and immunohistochemistry, after splenic excision, to be of endometrial origin. Together with this case presentation, several aspects of the disease and its differential diagnosis are discussed, in correlation with the current literature.
