Case 125

A 65 year old female with a large endometrial mass.

1. What's the FIGO staging of this tumor

   A: Endometrioid carcinoma, FIGO2

   B: Endometrioid carcinoma, FIGO3

   C: Mixed serous and endometrioid carcinoma, FIGO3

   D: Mixed serous and endometrioid carcinoma, FIGO2

Answer

The correct answer is B. This is a FIGO 3 endometroid carcinoma with solid area more than 50%. Sequencing results: POLE gene with pathogenic variant; MSI-stable; TMB-high.

POLE-ultramutated EC

Often high-grade, ambiguous morphology with scattered tumor giant cells, prominent TILs

NGS / Sanger sequencing / hotspot analysis for POLE includes

• p.Pro286Arg

• p.Val411Leu

• p.Ser297Phe

• p.Ala456Pro

• p.Ser459Phe
  

References: https://tumourclassification.iarc.who.int/attachment/34/223/10612

Case credit: UCSD Pathology

Author: Wangpan Jackson, Shi, MD