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Abstract
Introduction/Background Dedifferentiated endometrioid adenocarcinoma (DEAC) is rare and is known to be more aggressive than high-grade endometrioid carcinoma. DEAC may pose a variety of diagnostic challenges. DEAC is defined as a tumor which composed of a mixture of undifferentiated carcinoma and conventional endometrioid adenocarcinom.
Methodology This is a case report of DEAC with repair of external iliac arter with endovascular graft which was diagnosed in Ankara University Gynecologic. A 48-year-old perimenopausal woman (BMI: 40 kg/m2) was referred us endometrioid carcinoma FIGO grade 2 diagnose. She suffered from vaginal bleeding for 2 months.Transvaginal ultrasound revealed abnormally thickened endometrium (5,1 cm) and on examination a gross mass protruding from cervix shown and the entire of endometrial cavity is filled with this mass.Pathology reevoluated the endometrial biopsy and revealed DEAC (endometrioid endometrial carsinom grade 1 (%80) and undifferantiated carsinom (%20). MRI showed a 62*52*42 mm mass at lower uterine segment (figure 1C) extending to the cervix. MRI showed a 194*11*95 mm lobulated mass filling right pelvis sidewall.Abdominal pelvic computed tomography (CT) revealed that the mass involving bladder and rectum. TAH+BSO+partial cystectomy+low anterior resection+right external iliac artery repair with endovascular greft was performed. In surgery, pelvic mass was involving the right pelvic sidewall and in order to remove tumor totaly we cutted and removed external iliak artery and there was a 7 cm lenght defect at right external iliac artery. A 12 mm diameter and 7 cm lenght stretch vascular graft (GORE-TEX®) was placed to vascular defect and the graft patency was intact. We achieved complete en bloc tumor resection.
Results After surgery pathology revealed DEAC (endometrioid endometrial carsinom grade 3 and undifferantiate carsinom). And the patient died 1 week later after the surgery due to tumor lysis syndrome.
Conclusion Differentiating is important because DEACs have fulminant clinical outcomes and poorer prognosis than high-grade endometrioid carcinoma.
Disclosure Nothing to disclose.
Right external iliac artery defect
Repair of external iliac arter with endovascular graft