Table of Contents
Definition / general | Terminology | Clinical features | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosis | Additional referencesCite this page: Villoglandular carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/uterusvilloglandular.html. Accessed July 16th, 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 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:
Positive stains
Differential diagnosis
- Serous, mucinous, clear cell and transitional carcinomas
- Nonneoplastic, papillary proliferations with fibrous cores, lined by metaplastic cells
- Syncytial changes
- Arias-Stella reaction
Additional references



