Uterus
Carcinoma
Secretory carcinoma

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

Revised: 25 January 2017, last major update August 2011

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

PubMed search: secretory [title] carcinoma uterus

Cite this page: Secretory carcinoma. PathologyOutlines.com website. http://pathologyoutlines.com/topic/uterussecretory.html. Accessed March 25th, 2017.
Definition / General
  • Subtype of well differentiated endometrioid adenocarcinoma
Epidemiology
Etiology
  • In 1970s, disproportionate number of cases associated with young women using oracon, a sequential oral contraceptive agent with high estrogen and small progesterone content, no longer available (Cancer 1977;39:592, Fertil Steril 1976;27:346)
Clinical Features
  • 2/3 present after menopause with vaginal bleeding
  • Nulliparous and multiparous women
  • 50% of patients are obese
  • Favorable prognosis
Case Reports
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
  • Indistinguishable from other carcinomas on gross examination
  • May not be apparent on gross examination despite an obvious tumor on microscopic examination
  • May resemble late secretory phase endometrium
  • Visible tumors vary from sessile polyps to nodules or irregular, thickened plaques that may be localized or diffuse
Micro Description
  • Confluent, cribriform or villoglandular voluminous glands with glycogen, subnuclear vacuoles (resembles day 17 - 22 endometrium), plus late secretory pattern in uninvolved endometrium
  • Above pattern may coexist with conventional endometrioid pattern
  • FIGO grade 1 - 2 and nuclear grade 1
  • Corpus luteum typically present in ovaries, particularly in premenopausal women not on hormone therapy
Micro Images

Images hosted on PathOut server:

The glands at upper
left demonstrate
clear cytoplasm
due to glycogen

High power reveals
small regular nuclei
and abundant
vacuolated cytoplasm



Images hosted on other servers:

Prominent cytoplasmic vacuoles
and intraluminal secretions

Positive Stains
Negative Stains
Differential Diagnosis
Additional References