Showing one of my cases encountered

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Intro: It's an alt to blog about STEM topics. I'm segregating the topics I write on separate accounts to reduce clutter. You can just tag @adamada or this account when making a response.

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Tumor cells arranged in predominantly solid sheets. The cells are characterized by their round, pleomorphic nuclei with inconspicuous to prominent nucleoli with moderate to ample cytoplasm. Few mitosis are observed.

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This was a case of Endometrial Cancer, Endometrioid Type, 3cm Widest Tumor Dimension, with more than 50% myometrial wall invasion. FIGO Grade 3.

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I mentioned the steps it takes before signing out a diagnosis on my previous post. There are more sentences attached to the signed out case but those details serve little purpose here. It's just show and tell without going deeper and just dumbing down several details here. I'm a few days in the beginning of the hell week cycle again but this time it's more manageable than the first time.

Not going to bore you with medical jargon. I know less of the terms mentioned would ever stick to memory. Sharing with you how my case ended up being picked for presentation for the OB-Gyne Department. They got this regular monthly set of presentations for interesting cases in collaboration with the Pathology Department.

So we just lend a hand with our colleagues in making the presentation because we get asked if they can't answer for us. Not a pleasant experience by the way. We do inter-department rehearsals prior presentations.

The specimen (Uterus and attached organs) with an endometrial mass that has a fungating appearance. Came from an old female on their menopausal years.

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I took a sample of the mass and this is what the slides prepared had to show me (40x magnification). The upper left side shows some tubular glands but the mass is composed predominantly of solid sheets (occupying most of the picture) which makes the prognosis worse. The normal histology of the endometrium

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This is at 100x magnification focusing on the solid sheets

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At 400x magnification.

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This is at 40x magnification. You can see the tumor's solid sheets penetrating the myometrial wall. If it exceeds more than 50% of the wall, we class is as FIGO Grade 3. (Grade 1: <6% invasion, Grade 2: >6-<50% invasion). The serosal layer is not visible on this slide as it's difficult to accommodate it on the field due to it's size.

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The tumor invades the myometrium until it expands to other areas locally until it metastasizes. The grading system is used to prognosticate and guide clinical decisions in tackling the problem of how to treat these patients after removal.

The highest (Grade 3) may mean some extensive chemotherapy and radiotherapy depending on the patient's condition. The Endometrioid type of cancer (Type I) is 80% to 85% more common compared to Serous Type which has a worse prognosis. It derives it's name endometrioid because of the semblance it has with the normal endometrial lining while the Serous type tends to be bizarre (poorly differentiated).

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References:
Robbins and Cotran Pathologic Basis of Disease10th Ed
Rosai and Ackerman's Surgical Pathology 11th Ed.

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