Clear cell adenocarcinoma
Reviewer: Jamie Shutter, M.D., University of South Florida
Revised: 21 September 2012, last major update June 2010
Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.
● Tumor of post-menopausal patients that histologically resembles ovarian clear cell carcinoma with clear or hobnail cells
● ICD-O: 8310/3
● Also called clear cell carcinoma
● 1–5% of all endometrial adenocarcinoma
● Usually older, post-menopausal women
● A type II tumor (estrogen independent)
● Arises from atrophic endometrium (not endometrial hyperplasia), similar to serous carcinoma
● High grade tumors (automatically FIGO grade III) with aggressive behavior
● Poorer prognosis than high grade (grade 3) endometrioid adenocarcinoma (Br J Cancer 2006;94:642)
● If confined to corpus, has better prognosis than serous carcinoma of same stage
● 73 year old woman with tumor arising from adenomyosis (Int J Gynecol Pathol 2009;28:262)
Micro description (Histopathology)
● Papillary, tubular, tubulocystic or sheet-like architecture
● Large, clear to rarely eosinophilic cells with glycogen, distinct margins and hobnail cells
● May have colloid-like material in tubules
● Enlarged angulated nuclei with enlarged irregular nucleoli
● Usually associated with a putative precursor lesion of isolated glands or surface epithelium (within an otherwise normal endometrial region) that displays cytoplasmic clarity or eosinophilia with varying degrees of nuclear atypia (Am J Surg Pathol 2006;30:1519)
● Benign endometrium is usually atrophic, not hyperplastic
voluminous clear cytoplasm
Tubuloglandular growth with nuclear Tubuloglandular growth (left) blends
pleomorphism. Both clear and hobnail with a more solid pattern (right).
cells are present.
cells with pleomorphic, hyperchromatic clear cytoplasm, and bizarre, occasionally
nuclei, each with one or more prominent multiple nuclei resembling Arias-Stella
nucleoli. Voluminous clear cytoplasm is change. At lower magnification, this was an
present. obviously invasive malignant tumor.
p53 staining (figure 6)
● Clear cell change: no invasion, no atypia
● Endometrial EIN / atypical hyperplasia with clear cell change: not invasive, clear cells lack atypia (Ann Diagn Pathol 2003;7:381)
● Metastatic renal cell carcinoma
End of Uterus > Epithelial tumors > Clear cell carcinoma
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