Uterus
Carcinoma
Villoglandular carcinoma

Author: Mohamed Mokhtar Desouki, M.D., Ph.D. (see Authors page)

Revised: 26 January 2017, last major update July 2011

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

PubMed search: villoglandular carcinoma

Cite this page: Villoglandular carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/uterusvilloglandular.html. Accessed October 17th, 2017.
Definition / general
  • Rare variant of well differentiated, endometrioid adenocarcinoma
Terminology
  • Also called villoglandular endometrioid carcinoma (VGEC)
Clinical features
  • Most patients present after menopause with vaginal bleeding
  • 40% of tumors are pure VGEC, and the rest are mixed with typical endometrioid carcinoma foci
  • Similar behavior as mixed villoglandular / endometrioid carcinomas of similar grade (Am J Surg Pathol 1998;22:1379)
  • Myoinvasion predicts vascular invasion and nodal involvement
  • Villoglandular tumors with myometrial invasion may have poorer prognosis than nonvilloglandular tumors with myometrial invasion (Am J Surg Pathol 1994;18:569)
Treatment
  • TAH / BSO then possible radiation (for advanced disease) for disease limited to the uterus (NCCN Guidelines Version 1.2014); consideration of preoperative radiation for tumors grossly involving the cervix before doing surgery (this is uncommon)
Gross description
  • Visible tumors vary from sessile, fungating masses that fill the uterine cavity to nodules or irregular, thickened plaques that may be localized or diffuse
Microscopic (histologic) description
  • Dominant pattern is well differentiated, papillary structures
  • Cells resemble classic, glandular endometrioid pattern with uniform columnar cells and bland nuclei perpendicular to basement membrane
  • Thin and simple papillary structures without broad, fibrovascular cores
  • Squamous differentiation may be present, but bland without atypia
  • Note: biopsy diagnosis is often inaccurate (Acta Obstet Gynecol Scand 2009;88:355)
Microscopic (histologic) images

Images hosted on PathOut server:

Fig 69: The tumor cells are
well differentiated, but grow
in a papillary pattern rather
than a glandular pattern

Fig 70: Low magnification
shows the growth pattern
of this tumor


Fig 71: This case also illustrates
the villoglandular architecture;
see fig 72 for cellular detail (fig 71
and 72 are from the same patient)

Fig 72: Higher magnification of fig 71 shows typical features
of serous papillary adenocarcinomas: relatively uniform nuclei,
marked cellular stratification, cellular buds, exfoliation
of groups of cells into lumina, no / rare mitotic activity



Images hosted on other servers:

Various images

Positive stains
Negative stains
Differential diagnosis
Additional references