Clear cell adenocarcinoma

Author: Jamie Shutter, M.D. (see Authors page)

Revised: 20 January 2017, last major update June 2010

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed search: clear cell carcinoma uterus

Cite this page: Clear cell carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/uterusclearcell.html. Accessed October 20th, 2018.
Definition / general
  • 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, postmenopausal women
  • A type II tumor (estrogen independent)
  • Arises from atrophic endometrium (not endometrial hyperplasia), similar to serous carcinoma
Clinical features
  • 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
Case reports
Microscopic (histologic) description
  • 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
Microscopic (histologic) images

Images hosted on PathOut server:

Solid sheet of tumor cells with voluminous clear cytoplasm

Predominantly papillary growth

growth (left) blends
with a more solid
pattern (right)

Tubuloglandular growth
with nuclear pleomorph-
ism; both clear and hob-
nail cells are present

A solid focus of tumor is composed of cells
with pleomorphic, hyperchromatic nuclei,
each with one or more prominent nucleoli;
voluminous clear cytoplasm is present

This field shows cellular stratification, voluminous
clear cytoplasm, and bizarre, occasionally multiple
nuclei resembling Arias-Stella change; at lower magnifi-
cation, this was an obviously invasive malignant tumor

Images hosted on other servers:

p53 staining (figure 6)

Positive stains
Differential diagnosis