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| Figure 1: a: Histological diagnosis of endometrioid adenocarcinoma of grade 1 was obtained through multidirectional endometrial curettage. This procedure demonstrated confluent glands with a cribriform bridging arrangement in most areas (H&E, low power magnification). b: Microscopic findings for the endometrial curetted specimen after 16 weeks of progestin treatment showed small atrophic glands scattered in the background of predecidualstroma (H&E, low power magnification). This finding indicates complete remission. c: T2-weighted MRI (sagittal section) showed no abnormal findings and a thin endometrium. d: T2-weighted MRI (sagittal section) showed no endometrial abnormality, but a 3 cm abnormal mass (white arrowheads) was observed between the cervical wall and rectum, with a moderate amount of ascites. e: T2-weighted MRI (coronal section) indicated a suspected metastasis at the surface of the right hepatic lobe (white arrow). f: In laparotomy, a cul-de-sac tumor was found to have invaded the rectal wall. The cervical wall of the uterus and both ovaries looked normal. g: Microscopic observation (H&E, low power magnification) revealed foci of carcinomatous elements with strong epithelial connections, and sarcomatous elements with atypical cells losing epithelial arrangement and osseous formation. In other areas, various levels of differentiations of endometrioid, squamous, and clear cell carcinomas were observed with immature cartilaginous formation. h,i: Low power magnification of the ovarian cortex showed multiple (independent) foci of carcinoma. This finding suggests that the ovarian malignancy was more metastatic than the primary origin. |
