World Library  
Flag as Inappropriate
Email this Article

Uterine serous carcinoma

Article Id: WHEBN0019892408
Reproduction Date:

Title: Uterine serous carcinoma  
Author: World Heritage Encyclopedia
Language: English
Publisher: World Heritage Encyclopedia

Uterine serous carcinoma

Uterine papillary serous carcinoma
Classification and external resources
10 9 182

Uterine serous carcinoma (USC), also known as uterine papillary serous carcinoma (UPSC) and uterine serous adenocarcinoma, is an uncommon form of endometrial cancer that typically arises in postmenopausal women.

It is typically diagnosed on endometrial biopsy, prompted by post-menopausal bleeding.

Unlike the more common low-grade endometrioid endometrial adenocarcinoma, USC does not develop from endometrial hyperplasia and is not hormone-sensitive. It arises in the setting of endometrial atrophy and is classified as a type II endometrial cancer.[1]


The lesion is found in patients who present typically with abnormal or postmenopausal bleeding. Such bleeding is followed by further evaluation leading to a tissue diagnosis, usually done by a dilatation and curettage (D&C). A work-up to follow would look for metastasis using imaging technology including sonography and MRI. The median age at diagnosis in a study of 138 women was 67 years, of these 54 had stage I, 20 stage II, 41 stage III, and 23 stage IV disease.[2]

Histopathologically, uterine serous carcinomas is typically characterized by (1) nipple-shaped structures (papillae) with fibrovascular cores (2) marked nuclear atypia (irregularies in the nuclear membrane, enlarged nuclear size), (3) psammoma bodies and (4) cilia.


Prognosis of the UPSC is affected by age, stage, and histology as well as treatment.[2]


UPSC is staged like other forms of endometrial carcinoma at time of surgery using the FIGO cancer staging system.

  • Stage IA: tumor is limited to the endometrium
  • Stage IB: invasion of less than half the myometrium
  • Stage IC: invasion of more than half the myometrium
  • Stage IIA: endocervical glandular involvement only
  • Stage IIB: cervical stromal invasion
  • Stage IIIA: tumor invades serosa or adnexa, or malignant peritoneal cytology
  • Stage IIIB: vaginal metastasis
  • Stage IIIC: metastasis to pelvic or para-aortic lymph nodes
  • Stage IVA: invasion of the bladder or bowel
  • Stage IVB: distant metastasis, including intraabdominal or inguinal lymph nodes


In the older literature survival rates have been given as 35–50% for Stage I–II and 0–15% for Stage III and IV UPSC,[3] More recently it was reported that forty-two percent of 138 patients were found disease-free at five years.[2]

In 2009, the journal of "Gynecologic Oncology" reported the following 5-year survival rates based upon stage of cancer:

  • Stage I: 50% - 80%
  • Stage II: 50%
  • Stage III: 20%
  • Stage IV: 5% - 10% [4]


The primary treatment is surgical. FIGO-cancer staging is done at the time of surgery which consists of peritoneal cytology, total hysterectomy, bilateral salpingo-oophorectomy, pelvic/para-aortic lymphadenectomy, and omentectomy. The tumor is aggressive and spreads quickly into the myometrium and the lymphatic system. Thus even in presumed early stages, lymphadenectomy and omentectomy should be included in the surgical approach. If the tumor has spread surgery is cytoreductive followed by radiation therapy and/or chemotherapy.[3]

In a study to determine if adjuvant therapy should be used in patients with stage I UPSC who had undergone surgery, no increased survival was seen when radiation therapy was added versus observation, while the postsurgical treatment with chemotherapy may be beneficial but more data are needed.[5] A study of the usefulness of platinum-based chemotherapy as an adjuvant after surgery of stage I patients showed that patients with stage 1A who had no residual disease in the hysterectomy specimen had no recurrence regardless if chemotherapy was used or not, however, patients with stage 1A disease with residual disease in the hysterectomy specimen had no recurrence with platinum-based therapy, but those who had no such chemotherapy showed recurrence in 43%. Similarly, patients with stage 1B disease with chemotherapy had no recurrence, while those without chemotherapy had a high degree (77%) of recurrence.[6]


In a recent study, about 60% of USCs were found to overexpress the protein HER2/neu--the same one that is overexpressed in some breast cancers. The monoclonal antibody trastuzumab (Herceptin) is currently being tested as a therapy for this subset of USCs.[7]

The antibody trastuzumab (Herceptin), which is used to treat breast cancers that overexpress the HER2/neu protein, has been tried with some success in a phase II trial in women with UPSCs that overexpress HER2/neu.[7]


This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.

Copyright © World Library Foundation. All rights reserved. eBooks from World eBook Library are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.