Abstract
We present an instructive case of FIGO grade 1 endometrioid endometrial carcinoma with a biphasic morphology, corresponding to subclonal loss of mismatch repair proteins (MMRP) MLH1 and PMS2 by immunohistochemistry and subclonal microsatellite instability. A pulmonary metastasis represented only the tumor component with retention of MMRPs. This case illustrates the need for pathologists to recognize and report heterogenous expression of MMRPs in endometrial carcinoma, to consider tumor heterogeneity when selecting foci for molecular studies, and to re-evaluate MMRP expression in tumor metastases, when clinically indicated. These considerations are particularly important as the relevance of MMRP expression in endometrial cancer expands beyond Lynch syndrome screening, into a new role as a predictive marker for immunotherapy.
References
Feb 14, 2009·Clinical Genetics·E BarrowD G Evans
Apr 27, 2011·International Journal of Cancer. Journal International Du Cancer·Christophe TresalletHélène Hofmann-Radvanyi
Jun 7, 2011·JAMA : the Journal of the American Medical Association·Valérie BonadonaUNKNOWN French Cancer Genetics Network
Nov 25, 2011·Gynecologic Oncology·Kara C LongNadeem R Abu-Rustum
Apr 3, 2013·Familial Cancer·C Richard Boland, Henry T Lynch
Jan 27, 2015·Gynecologic Oncology·Antonina I FrolovaDavid G Mutch
Mar 19, 2015·The American Journal of Surgical Pathology·Rish K PaiAndres R Roma
Jul 15, 2015·British Journal of Cancer·A TalhoukJ N McAlpine
May 18, 2016·The American Journal of Surgical Pathology·Jaclyn C WatkinsLynette M Sholl
Aug 25, 2016·International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists·Jaclyn C WatkinsBrooke E Howitt
Nov 12, 2016·The Journal of Molecular Diagnostics : JMD·Sabah KadriJeremy P Segal
Mar 11, 2017·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Katherine C KurnitRussell R Broaddus
May 11, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Patrick A OttJean-Charles Soria
Nov 7, 2017·Human Pathology·Jessica L DillonLaura J Tafe
Apr 17, 2018·Gynecologic Oncology·David B ChapelRicardo R Lastra