Skip to main content

Pathology of Gynecologic Cancer

  • Chapter
  • First Online:
Management of Gynecological Cancers in Older Women
  • 758 Accesses

Abstract

This chapter will discuss the basic pathology of select gynecologic malignancies that occur in older women. First, endometrial cancer will be reviewed, including endometrioid carcinoma, the most common subtype, as well as less common entities such as serous and undifferentiated carcinoma and MMMT. Tamoxifen-associated endometrial cancer as well as Lynch syndrome, an important disorder in endometrial as well as ovarian cancer, will be briefly touched upon. Next, ovarian epithelial malignancies will be discussed with special attention to serous carcinoma and its association with BRCA abnormalities. Endometrioid, clear cell, and mucinous ovarian neoplasms will also be briefly discussed. Finally, the most common carcinomas of the cervix and vulva are reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983;15(1):10–7.

    PubMed  CAS  Google Scholar 

  2. Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long-term study of “untreated” hyperplasia in 170 patients. Cancer. 1985;56(2):403–12.

    PubMed  CAS  Google Scholar 

  3. Zaino RJ, et al. Reproducibility of the diagnosis of atypical endometrial hyperplasia: a Gynecologic Oncology Group study. Cancer. 2006;106(4):804–11.

    PubMed  Google Scholar 

  4. Trimble CL, et al. Concurrent endometrial carcinoma in women with a biopsy diagnosis of atypical endometrial hyperplasia: a Gynecologic Oncology Group study. Cancer. 2006;106(4):812–9.

    PubMed  Google Scholar 

  5. Leitao Jr MM, et al. Complex atypical hyperplasia of the uterus: characteristics and prediction of underlying carcinoma risk. Am J Obstet Gynecol. 2010;203(4):349.e1–6.

    Google Scholar 

  6. Zaino RJ, et al. The utility of the revised International Federation of Gynecology and Obstetrics histologic grading of endometrial adenocarcinoma using a defined nuclear grading system. A Gynecologic Oncology Group study. Cancer. 1995;75(1):81–6.

    PubMed  CAS  Google Scholar 

  7. Alkushi A, et al. Description of a novel system for grading of endometrial carcinoma and comparison with existing grading systems. Am J Surg Pathol. 2005;29(3):295–304.

    PubMed  Google Scholar 

  8. Taylor RR, et al. An analysis of two versus three grades for endometrial carcinoma. Gynecol Oncol. 1999;74(1):3–6.

    PubMed  CAS  Google Scholar 

  9. Scholten AN, et al. Prognostic significance and interobserver variability of histologic grading systems for endometrial carcinoma. Cancer. 2004;100(4):764–72.

    PubMed  Google Scholar 

  10. Gemer O, et al. The reproducibility of histological parameters employed in the novel binary grading systems of endometrial cancer. Eur J Surg Oncol. 2009;35(3):247–51.

    PubMed  CAS  Google Scholar 

  11. Nofech-Mozes S, et al. Endometrial endometrioid adenocarcinoma: a pathologic analysis of 827 consecutive cases. Am J Clin Pathol. 2008;129(1):110–4.

    PubMed  Google Scholar 

  12. Hamilton CA, et al. Uterine papillary serous and clear cell carcinomas predict for poorer ­survival compared to grade 3 endometrioid corpus cancers. Br J Cancer. 2006;94(5):642–6.

    PubMed  CAS  Google Scholar 

  13. Soslow RA, et al. Clinicopathologic analysis of 187 high-grade endometrial carcinomas of ­different histologic subtypes: similar outcomes belie distinctive biologic differences. Am J Surg Pathol. 2007;31(7):979–87.

    PubMed  Google Scholar 

  14. Voss MA, et al. Should grade 3 endometrioid endometrial carcinoma be considered a type 2 cancer-A clinical and pathological evaluation. Gynecol Oncol. 2012;124(1):15–20.

    PubMed  Google Scholar 

  15. Jacques SM, Qureshi F, Lawrence WD. Surface epithelial changes in endometrial adenocarcinoma: diagnostic pitfalls in curettage specimens. Int J Gynecol Pathol. 1995;14(3):191–7.

    PubMed  CAS  Google Scholar 

  16. Pitman MB, et al. Endometrioid carcinoma of the ovary and endometrium, oxyphilic cell type: a report of nine cases. Int J Gynecol Pathol. 1994;13(4):290–301.

    PubMed  CAS  Google Scholar 

  17. Nogales FF, et al. Benign heterologous tissue components associated with endometrial carcinoma. Int J Gynecol Pathol. 1982;1(3):286–91.

    PubMed  CAS  Google Scholar 

  18. Silva EG, Young RH. Endometrioid neoplasms with clear cells: a report of 21 cases in which the alteration is not of typical secretory type. Am J Surg Pathol. 2007;31(8):1203–8.

    PubMed  Google Scholar 

  19. Murray SK, Clement PB, Young RH. Endometrioid carcinomas of the uterine corpus with sex cord-like formations, hyalinization, and other unusual morphologic features: a report of 31 cases of a neoplasm that may be confused with carcinosarcoma and other uterine neoplasms. Am J Surg Pathol. 2005;29(2):157–66.

    PubMed  Google Scholar 

  20. Eichhorn JH, Young RH, Clement PB. Sertoliform endometrial adenocarcinoma: a study of four cases. Int J Gynecol Pathol. 1996;15(2):119–26.

    PubMed  CAS  Google Scholar 

  21. Murray SK, Young RH, Scully RE. Unusual epithelial and stromal changes in myoinvasive endometrioid adenocarcinoma: a study of their frequency, associated diagnostic problems, and prognostic significance. Int J Gynecol Pathol. 2003;22(4):324–33.

    PubMed  Google Scholar 

  22. Pavlakis K, et al. MELF invasion in endometrial cancer as a risk factor for lymph node metastasis. Histopathology. 2011;58(6):966–73.

    PubMed  Google Scholar 

  23. Stewart CJ, et al. MELF pattern invasion in endometrial carcinoma: association with low grade, myoinvasive endometrioid tumours, focal mucinous differentiation and vascular invasion. Pathology. 2009;41(5):454–9.

    PubMed  CAS  Google Scholar 

  24. McKenney JK, Kong CS, Longacre TA. Endometrial adenocarcinoma associated with subtle lymph-vascular space invasion and lymph node metastasis: a histologic pattern mimicking intravascular and sinusoidal histiocytes. Int J Gynecol Pathol. 2005;24(1):73–8.

    PubMed  Google Scholar 

  25. Prat J, et al. Endometrial carcinoma: pathology and genetics. Pathology. 2007;39(1):72–87.

    PubMed  CAS  Google Scholar 

  26. Hendrickson M, et al. Uterine papillary serous carcinoma: a highly malignant form of endometrial adenocarcinoma. Am J Surg Pathol. 1982;6(2):93–108.

    PubMed  CAS  Google Scholar 

  27. Ambros RA, et al. Endometrial intraepithelial carcinoma: a distinctive lesion specifically associated with tumors displaying serous differentiation. Hum Pathol. 1995;26(11):1260–7.

    PubMed  CAS  Google Scholar 

  28. Slomovitz BM, et al. Uterine papillary serous carcinoma (UPSC): a single institution review of 129 cases. Gynecol Oncol. 2003;91(3):463–9.

    PubMed  Google Scholar 

  29. Lax SF, et al. The frequency of p53, K-ras mutations, and microsatellite instability differs in uterine endometrioid and serous carcinoma: evidence of distinct molecular genetic pathways. Cancer. 2000;88(4):814–24.

    PubMed  CAS  Google Scholar 

  30. Tashiro H, et al. p53 gene mutations are common in uterine serous carcinoma and occur early in their pathogenesis. Am J Pathol. 1997;150(1):177–85.

    PubMed  CAS  Google Scholar 

  31. Sherman ME, Bur ME, Kurman RJ. p53 in endometrial cancer and its putative precursors: evidence for diverse pathways of tumorigenesis. Hum Pathol. 1995;26(11):1268–74.

    PubMed  CAS  Google Scholar 

  32. Baergen RN, et al. Early uterine serous carcinoma: clonal origin of extrauterine disease. Int J Gynecol Pathol. 2001;20(3):214–9.

    PubMed  CAS  Google Scholar 

  33. Abeler VM, Kjorstad KE. Clear cell carcinoma of the endometrium: a histopathological and clinical study of 97 cases. Gynecol Oncol. 1991;40(3):207–17.

    PubMed  CAS  Google Scholar 

  34. Clement PB, Young RH. Non-endometrioid carcinomas of the uterine corpus: a review of their pathology with emphasis on recent advances and problematic aspects. Adv Anat Pathol. 2004;11(3):117–42.

    PubMed  Google Scholar 

  35. Silverberg SG, De Giorgi LS. Clear cell carcinoma of the endometrium. Clinical, pathologic, and ultrastructural findings. Cancer. 1973;31(5):1127–40.

    PubMed  CAS  Google Scholar 

  36. Kurman RJ, Scully RE. Clear cell carcinoma of the endometrium: an analysis of 21 cases. Cancer. 1976;37(2):872–82.

    PubMed  CAS  Google Scholar 

  37. Malpica A, et al. Low-stage clear-cell carcinoma of the endometrium. Am J Surg Pathol. 1995;19(7):769–74.

    PubMed  CAS  Google Scholar 

  38. Vang R, et al. Immunohistochemical analysis of clear cell carcinoma of the gynecologic tract. Int J Gynecol Pathol. 2001;20(3):252–9.

    PubMed  CAS  Google Scholar 

  39. Lax SF, et al. Clear cell carcinoma of the endometrium is characterized by a distinctive profile of p53, Ki-67, estrogen, and progesterone receptor expression. Hum Pathol. 1998;29(6):551–8.

    PubMed  CAS  Google Scholar 

  40. An HJ, et al. Molecular characterization of uterine clear cell carcinoma. Mod Pathol. 2004;17(5):530–7.

    PubMed  CAS  Google Scholar 

  41. Altrabulsi B, et al. Undifferentiated carcinoma of the endometrium. Am J Surg Pathol. 2005;29(10):1316–21.

    PubMed  Google Scholar 

  42. Garg K, et al. Selection of endometrial carcinomas for DNA mismatch repair protein immunohistochemistry using patient age and tumor morphology enhances detection of mismatch repair abnormalities. Am J Surg Pathol. 2009;33(6):925–33.

    PubMed  Google Scholar 

  43. Broaddus RR, et al. Pathologic features of endometrial carcinoma associated with HNPCC: a comparison with sporadic endometrial carcinoma. Cancer. 2006;106(1):87–94.

    PubMed  CAS  Google Scholar 

  44. Brooks SE, et al. Surveillance, epidemiology, and end results analysis of 2677 cases of uterine sarcoma 1989–1999. Gynecol Oncol. 2004;93(1):204–8.

    PubMed  Google Scholar 

  45. Schlesinger C, et al. Endometrial polyps: a comparison study of patients receiving tamoxifen with two control groups. Int J Gynecol Pathol. 1998;17(4):302–11.

    PubMed  CAS  Google Scholar 

  46. Cohen I, et al. Malignant endometrial polyps in postmenopausal breast cancer tamoxifen-treated patients. Gynecol Oncol. 1999;75(1):136–41.

    PubMed  CAS  Google Scholar 

  47. Senkus-Konefka E, Konefka T, Jassem J. The effects of tamoxifen on the female genital tract. Cancer Treat Rev. 2004;30(3):291–301.

    PubMed  CAS  Google Scholar 

  48. Deligdisch L, et al. Endometrial histopathology in 700 patients treated with tamoxifen for breast cancer. Gynecol Oncol. 2000;78(2):181–6.

    PubMed  CAS  Google Scholar 

  49. Barakat RR, et al. Tamoxifen use in breast cancer patients who subsequently develop corpus cancer is not associated with a higher incidence of adverse histologic features. Gynecol Oncol. 1994;55(2):164–8.

    PubMed  CAS  Google Scholar 

  50. Dallenbach-Hellweg G, et al. The endometrium in breast cancer patients on tamoxifen. Arch Gynecol Obstet. 2000;263(4):170–7.

    PubMed  CAS  Google Scholar 

  51. Ferguson SE, et al. Comparison of uterine malignancies that develop during and following tamoxifen therapy. Gynecol Oncol. 2006;101(2):322–6.

    PubMed  CAS  Google Scholar 

  52. Lynch HT, de la Chapelle A. Genetic susceptibility to non-polyposis colorectal cancer. J Med Genet. 1999;36(11):801–18.

    PubMed  CAS  Google Scholar 

  53. Watson P, et al. The risk of endometrial cancer in hereditary nonpolyposis colorectal cancer. Am J Med. 1994;96(6):516–20.

    PubMed  CAS  Google Scholar 

  54. Aarnio M, et al. Cancer risk in mutation carriers of DNA-mismatch-repair genes. Int J Cancer. 1999;81(2):214–8.

    PubMed  CAS  Google Scholar 

  55. Loeb LA. Microsatellite instability: marker of a mutator phenotype in cancer. Cancer Res. 1994;54(19):5059–63.

    PubMed  CAS  Google Scholar 

  56. Esteller M, et al. MLH1 promoter hypermethylation is associated with the microsatellite instability phenotype in sporadic endometrial carcinomas. Oncogene. 1998;17(18):2413–7.

    PubMed  CAS  Google Scholar 

  57. Gurin CC, et al. Causes and consequences of microsatellite instability in endometrial carcinoma. Cancer Res. 1999;59(2):462–6.

    PubMed  CAS  Google Scholar 

  58. Lu KH, et al. Gynecologic cancer as a “sentinel cancer” for women with hereditary nonpolyposis colorectal cancer syndrome. Obstet Gynecol. 2005;105(3):569–74.

    PubMed  Google Scholar 

  59. Berends MJ, et al. Molecular and clinical characteristics of MSH6 variants: an analysis of 25 index carriers of a germline variant. Am J Hum Genet. 2002;70(1):26–37.

    PubMed  CAS  Google Scholar 

  60. Hendriks YM, et al. Cancer risk in hereditary nonpolyposis colorectal cancer due to MSH6 mutations: impact on counseling and surveillance. Gastroenterology. 2004;127(1):17–25.

    PubMed  CAS  Google Scholar 

  61. Dunlop MG, et al. Cancer risk associated with germline DNA mismatch repair gene mutations. Hum Mol Genet. 1997;6(1):105–10.

    PubMed  CAS  Google Scholar 

  62. Goodfellow PJ, et al. Prevalence of defective DNA mismatch repair and MSH6 mutation in an unselected series of endometrial cancers. Proc Natl Acad Sci USA. 2003;100(10):5908–13.

    PubMed  CAS  Google Scholar 

  63. Hampel H, et al. Screening for Lynch syndrome (hereditary nonpolyposis colorectal cancer) among endometrial cancer patients. Cancer Res. 2006;66(15):7810–7.

    PubMed  CAS  Google Scholar 

  64. Westin SN, et al. Carcinoma of the lower uterine segment: a newly described association with Lynch syndrome. J Clin Oncol. 2008;26(36):5965–71.

    PubMed  Google Scholar 

  65. Carcangiu ML, et al. Lynch syndrome–related endometrial carcinomas show a high frequency of nonendometrioid types and of high FIGO grade endometrioid types. Int J Surg Pathol. 2010;18(1):21–6.

    PubMed  Google Scholar 

  66. Shia J, et al. Routinely assessed morphological features correlate with microsatellite instability status in endometrial cancer. Hum Pathol. 2008;39(1):116–25.

    PubMed  CAS  Google Scholar 

  67. Modica I, et al. Utility of immunohistochemistry in predicting microsatellite instability in endometrial carcinoma. Am J Surg Pathol. 2007;31(5):744–51.

    PubMed  Google Scholar 

  68. Jemal A, et al. Cancer statistics, 2010. CA Cancer J Clin. 2010;60(5):277–300.

    PubMed  Google Scholar 

  69. Seidman JD, et al. The histologic type and stage distribution of ovarian carcinomas of surface epithelial origin. Int J Gynecol Pathol. 2004;23(1):41–4.

    PubMed  Google Scholar 

  70. Malpica A, et al. Grading ovarian serous carcinoma using a two-tier system. Am J Surg Pathol. 2004;28(4):496–504.

    PubMed  Google Scholar 

  71. Malpica A, et al. Interobserver and intraobserver variability of a two-tier system for grading ovarian serous carcinoma. Am J Surg Pathol. 2007;31(8):1168–74.

    PubMed  Google Scholar 

  72. Singer G, et al. Mutations in BRAF and KRAS characterize the development of low-grade ovarian serous carcinoma. J Natl Cancer Inst. 2003;95(6):484–6.

    PubMed  CAS  Google Scholar 

  73. Singer G, et al. Diverse tumorigenic pathways in ovarian serous carcinoma. Am J Pathol. 2002;160(4):1223–8.

    PubMed  CAS  Google Scholar 

  74. Singer G, et al. Patterns of p53 mutations separate ovarian serous borderline tumors and low- and high-grade carcinomas and provide support for a new model of ovarian carcinogenesis: a mutational analysis with immunohistochemical correlation. Am J Surg Pathol. 2005;29(2):218–24.

    PubMed  Google Scholar 

  75. Salani R, et al. Assessment of TP53 mutation using purified tissue samples of ovarian serous carcinomas reveals a higher mutation rate than previously reported and does not correlate with drug resistance. Int J Gynecol Cancer. 2008;18(3):487–91.

    PubMed  CAS  Google Scholar 

  76. Risch HA, et al. Prevalence and penetrance of germline BRCA1 and BRCA2 mutations in a population series of 649 women with ovarian cancer. Am J Hum Genet. 2001;68(3):700–10.

    PubMed  CAS  Google Scholar 

  77. King MC, Marks JH, Mandell JB. Breast and ovarian cancer risks due to inherited mutations in BRCA1 and BRCA2. Science. 2003;302(5645):643–6.

    PubMed  CAS  Google Scholar 

  78. Rebbeck TR, et al. Prophylactic oophorectomy in carriers of BRCA1 or BRCA2 mutations. N Engl J Med. 2002;346(21):1616–22.

    PubMed  Google Scholar 

  79. Kauff ND, et al. Risk-reducing salpingo-oophorectomy in women with a BRCA1 or BRCA2 mutation. N Engl J Med. 2002;346(21):1609–15.

    PubMed  Google Scholar 

  80. Finch A, et al. Clinical and pathologic findings of prophylactic salpingo-oophorectomies in 159 BRCA1 and BRCA2 carriers. Gynecol Oncol. 2006;100(1):58–64.

    PubMed  CAS  Google Scholar 

  81. Colgan TJ, et al. Occult carcinoma in prophylactic oophorectomy specimens: prevalence and association with BRCA germline mutation status. Am J Surg Pathol. 2001;25(10):1283–9.

    PubMed  CAS  Google Scholar 

  82. Powell CB, et al. Risk-reducing salpingo-oophorectomy in BRCA mutation carriers: role of serial sectioning in the detection of occult malignancy. J Clin Oncol. 2005;23(1):127–32.

    PubMed  Google Scholar 

  83. Medeiros F, et al. The tubal fimbria is a preferred site for early adenocarcinoma in women with familial ovarian cancer syndrome. Am J Surg Pathol. 2006;30(2):230–6.

    PubMed  Google Scholar 

  84. Callahan MJ, et al. Primary fallopian tube malignancies in BRCA-positive women undergoing surgery for ovarian cancer risk reduction. J Clin Oncol. 2007;25(25):3985–90.

    PubMed  Google Scholar 

  85. Lee Y, et al. Advances in the recognition of tubal intraepithelial carcinoma: applications to cancer screening and the pathogenesis of ovarian cancer. Adv Anat Pathol. 2006;13(1):1–7.

    PubMed  Google Scholar 

  86. Press JZ, et al. Ovarian carcinomas with genetic and epigenetic BRCA1 loss have distinct molecular abnormalities. BMC Cancer. 2008;8:17.

    PubMed  Google Scholar 

  87. Kindelberger DW, et al. Intraepithelial carcinoma of the fimbria and pelvic serous carcinoma: evidence for a causal relationship. Am J Surg Pathol. 2007;31(2):161–9.

    PubMed  Google Scholar 

  88. Soslow RA, et al. Morphologic patterns associated with BRCA1 and BRCA2 genotype in ovarian carcinoma. Mod Pathol. 2012;25:625–36. Epub 2011 Dec 23.

    PubMed  CAS  Google Scholar 

  89. Leitao Jr MM, et al. Clinicopathologic analysis of early-stage sporadic ovarian carcinoma. Am J Surg Pathol. 2004;28(2):147–59.

    PubMed  Google Scholar 

  90. Acs G, Pasha T, Zhang PJ. WT1 is differentially expressed in serous, endometrioid, clear cell, and mucinous carcinomas of the peritoneum, fallopian tube, ovary, and endometrium. Int J Gynecol Pathol. 2004;23(2):110–8.

    PubMed  Google Scholar 

  91. Shimizu M, et al. Immunohistochemical detection of the Wilms’ tumor gene (WT1) in epithelial ovarian tumors. Int J Gynecol Pathol. 2000;19(2):158–63.

    PubMed  CAS  Google Scholar 

  92. Oliva E, et al. High frequency of beta-catenin mutations in borderline endometrioid tumours of the ovary. J Pathol. 2006;208(5):708–13.

    PubMed  CAS  Google Scholar 

  93. Wu R, et al. Diverse mechanisms of beta-catenin deregulation in ovarian endometrioid adenocarcinomas. Cancer Res. 2001;61(22):8247–55.

    PubMed  CAS  Google Scholar 

  94. Sato N, et al. Loss of heterozygosity on 10q23.3 and mutation of the tumor suppressor gene PTEN in benign endometrial cyst of the ovary: possible sequence progression from benign endometrial cyst to endometrioid carcinoma and clear cell carcinoma of the ovary. Cancer Res. 2000;60(24):7052–6.

    PubMed  CAS  Google Scholar 

  95. Lynch HT, et al. Review of the Lynch syndrome: history, molecular genetics, screening, differential diagnosis, and medicolegal ramifications. Clin Genet. 2009;76(1):1–18.

    PubMed  CAS  Google Scholar 

  96. Crozier MA, et al. Clear cell carcinoma of the ovary: a study of 59 cases. Gynecol Oncol. 1989;35(2):199–203.

    PubMed  CAS  Google Scholar 

  97. Pectasides D, et al. Treatment issues in clear cell carcinoma of the ovary: a different entity? Oncologist. 2006;11(10):1089–94.

    PubMed  Google Scholar 

  98. Sugiyama T, et al. Clinical characteristics of clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy. Cancer. 2000;88(11):2584–9.

    PubMed  CAS  Google Scholar 

  99. Kobel M, et al. Tumor type and substage predict survival in stage I and II ovarian carcinoma: insights and implications. Gynecol Oncol. 2010;116(1):50–6.

    PubMed  Google Scholar 

  100. Kuo KT, et al. Frequent activating mutations of PIK3CA in ovarian clear cell carcinoma. Am J Pathol. 2009;174(5):1597–601.

    PubMed  CAS  Google Scholar 

  101. Campbell IG, et al. Mutation of the PIK3CA gene in ovarian and breast cancer. Cancer Res. 2004;64(21):7678–81.

    PubMed  CAS  Google Scholar 

  102. Wiegand KC, et al. ARID1A mutations in endometriosis-associated ovarian carcinomas. N Engl J Med. 2010;363(16):1532–43.

    PubMed  CAS  Google Scholar 

  103. Jones S, et al. Frequent mutations of chromatin remodeling gene ARID1A in ovarian clear cell carcinoma. Science. 2010;330(6001):228–31.

    PubMed  CAS  Google Scholar 

  104. Kobel M, et al. Ovarian carcinoma subtypes are different diseases: implications for biomarker studies. PLoS Med. 2008;5(12):e232.

    PubMed  Google Scholar 

  105. Kennedy AW, et al. Ovarian clear cell adenocarcinoma. Gynecol Oncol. 1989;32(3):342–9.

    PubMed  CAS  Google Scholar 

  106. DeLair D, et al. Morphologic spectrum of immunohistochemically characterized clear cell carcinoma of the ovary: a study of 155 cases. Am J Surg Pathol. 2011;35(1):36–44.

    PubMed  Google Scholar 

  107. Kobel M, et al. A limited panel of immunomarkers can reliably distinguish between clear cell and high-grade serous carcinoma of the ovary. Am J Surg Pathol. 2009;33(1):14–21.

    PubMed  Google Scholar 

  108. Koonings PP, et al. Relative frequency of primary ovarian neoplasms: a 10-year review. Obstet Gynecol. 1989;74(6):921–6.

    PubMed  CAS  Google Scholar 

  109. Kobel M, et al. Differences in tumor type in low-stage versus high-stage ovarian carcinomas. Int J Gynecol Pathol. 2010;29(3):203–11.

    PubMed  Google Scholar 

  110. Ronnett BM, et al. Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis. A clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to “pseudomyxoma peritonei”. Am J Surg Pathol. 1995;19(12):1390–408.

    PubMed  CAS  Google Scholar 

  111. Ronnett BM, et al. Immunohistochemical evidence supporting the appendiceal origin of pseudomyxoma peritonei in women. Int J Gynecol Pathol. 1997;16(1):1–9.

    PubMed  CAS  Google Scholar 

  112. Lee KR, Young RH. The distinction between primary and metastatic mucinous carcinomas of the ovary: gross and histologic findings in 50 cases. Am J Surg Pathol. 2003;27(3):281–92.

    PubMed  Google Scholar 

  113. Seidman JD, Kurman RJ, Ronnett BM. Primary and metastatic mucinous adenocarcinomas in the ovaries: incidence in routine practice with a new approach to improve intraoperative diagnosis. Am J Surg Pathol. 2003;27(7):985–93.

    PubMed  Google Scholar 

  114. Harlow BL, Weiss NS, Lofton S. The epidemiology of sarcomas of the uterus. J Natl Cancer Inst. 1986;76(3):399–402.

    PubMed  CAS  Google Scholar 

  115. Gadducci A, et al. Uterine leiomyosarcoma: analysis of treatment failures and survival. Gynecol Oncol. 1996;62(1):25–32.

    PubMed  CAS  Google Scholar 

  116. Bell SW, Kempson RL, Hendrickson MR. Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases. Am J Surg Pathol. 1994;18(6):535–58.

    PubMed  CAS  Google Scholar 

  117. Schlecht NF, et al. Human papillomavirus infection and time to progression and regression of cervical intraepithelial neoplasia. J Natl Cancer Inst. 2003;95(17):1336–43.

    PubMed  Google Scholar 

  118. Ostor AG. Natural history of cervical intraepithelial neoplasia: a critical review. Int J Gynecol Pathol. 1993;12(2):186–92.

    PubMed  CAS  Google Scholar 

  119. Vinokurova S, et al. Clonal history of papillomavirus-induced dysplasia in the female lower genital tract. J Natl Cancer Inst. 2005;97(24):1816–21.

    PubMed  CAS  Google Scholar 

  120. Dalla Palma P, et al. The reproducibility of CIN diagnoses among different pathologists: data from histology reviews from a multicenter randomized study. Am J Clin Pathol. 2009;132(1):125–32.

    PubMed  Google Scholar 

  121. Klaes R, et al. Overexpression of p16(INK4A) as a specific marker for dysplastic and neoplastic epithelial cells of the cervix uteri. Int J Cancer. 2001;92(2):276–84.

    PubMed  CAS  Google Scholar 

  122. Agoff SN, et al. p16(INK4a) expression correlates with degree of cervical neoplasia: a comparison with Ki-67 expression and detection of high-risk HPV types. Mod Pathol. 2003;16(7):665–73.

    PubMed  Google Scholar 

  123. Keating JT, et al. Ki-67, cyclin E, and p16INK4 are complimentary surrogate biomarkers for human papilloma virus-related cervical neoplasia. Am J Surg Pathol. 2001;25(7):884–91.

    PubMed  CAS  Google Scholar 

  124. Brinck U, et al. Papillary squamous cell carcinoma of the uterine cervix: report of three cases and a review of its classification. Int J Gynecol Pathol. 2000;19(3):231–5.

    PubMed  CAS  Google Scholar 

  125. Tseng CJ, et al. Lymphoepithelioma-like carcinoma of the uterine cervix: association with Epstein-Barr virus and human papillomavirus. Cancer. 1997;80(1):91–7.

    PubMed  CAS  Google Scholar 

  126. Weinberg E, et al. Uterine cervical lymphoepithelial-like carcinoma. Absence of Epstein-Barr virus genomes. Am J Clin Pathol. 1993;99(2):195–9.

    PubMed  CAS  Google Scholar 

  127. Lininger RA, et al. Human papillomavirus type 16 is detected in transitional cell carcinomas and squamotransitional cell carcinomas of the cervix and endometrium. Cancer. 1998;83(3):521–7.

    PubMed  CAS  Google Scholar 

  128. Tase T, et al. Human papillomavirus DNA in adenocarcinoma in situ, microinvasive adenocarcinoma of the uterine cervix, and coexisting cervical squamous intraepithelial neoplasia. Int J Gynecol Pathol. 1989;8(1):8–17.

    PubMed  CAS  Google Scholar 

  129. Bertrand M, Lickrish GM, Colgan TJ. The anatomic distribution of cervical adenocarcinoma in situ: implications for treatment. Am J Obstet Gynecol. 1987;157(1):21–5.

    PubMed  CAS  Google Scholar 

  130. Smith HO, et al. The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the United States – a 24-year population-based study. Gynecol Oncol. 2000;78(2):97–105.

    PubMed  CAS  Google Scholar 

  131. Saraiya M, et al. Incidence of in situ and invasive vulvar cancer in the US, 1998–2003. Cancer. 2008;113(10 Suppl):2865–72.

    PubMed  Google Scholar 

  132. van de Nieuwenhof HP, et al. Vulvar squamous cell carcinoma development after diagnosis of VIN increases with age. Eur J Cancer. 2009;45(5):851–6.

    PubMed  Google Scholar 

  133. Scurry J, et al. Pathologic audit of 164 consecutive cases of vulvar intraepithelial neoplasia. Int J Gynecol Pathol. 2006;25(2):176–81.

    PubMed  Google Scholar 

  134. Preti M, et al. Inter-observer variation in histopathological diagnosis and grading of vulvar intraepithelial neoplasia: results of an European collaborative study. BJOG. 2000;107(5):594–9.

    PubMed  CAS  Google Scholar 

  135. Sideri M, et al. Squamous vulvar intraepithelial neoplasia: 2004 modified terminology, ISSVD Vulvar Oncology Subcommittee. J Reprod Med. 2005;50(11):807–10.

    PubMed  Google Scholar 

  136. Srodon M, et al. The distribution of low and high-risk HPV types in vulvar and vaginal intraepithelial neoplasia (VIN and VaIN). Am J Surg Pathol. 2006;30(12):1513–8.

    PubMed  Google Scholar 

  137. Logani S, et al. Low-grade vulvar and vaginal intraepithelial neoplasia: correlation of histologic features with human papillomavirus DNA detection and MIB-1 immunostaining. Mod Pathol. 2003;16(8):735–41.

    PubMed  Google Scholar 

  138. Jones RW, Rowan DM, Stewart AW. Vulvar intraepithelial neoplasia: aspects of the natural history and outcome in 405 women. Obstet Gynecol. 2005;106(6):1319–26.

    PubMed  Google Scholar 

  139. van Seters M, van Beurden M, de Craen AJ. Is the assumed natural history of vulvar intraepithelial neoplasia III based on enough evidence? A systematic review of 3322 published patients. Gynecol Oncol. 2005;97(2):645–51.

    PubMed  Google Scholar 

  140. Carlson JA, et al. Vulvar lichen sclerosus and squamous cell carcinoma: a cohort, case control, and investigational study with historical perspective; implications for chronic inflammation and sclerosis in the development of neoplasia. Hum Pathol. 1998;29(9):932–48.

    PubMed  CAS  Google Scholar 

  141. Yang B, Hart WR. Vulvar intraepithelial neoplasia of the simplex (differentiated) type: a clinicopathologic study including analysis of HPV and p53 expression. Am J Surg Pathol. 2000;24(3):429–41.

    PubMed  CAS  Google Scholar 

  142. Rolfe KJ, et al. TP53 mutations in vulval lichen sclerosus adjacent to squamous cell carcinoma of the vulva. Br J Cancer. 2003;89(12):2249–53.

    PubMed  CAS  Google Scholar 

  143. Ngan HY, et al. Abnormal expression or mutation of TP53 and HPV in vulvar cancer. Eur J Cancer. 1999;35(3):481–4.

    PubMed  CAS  Google Scholar 

  144. Eva LJ, et al. Differentiated-type vulval intraepithelial neoplasia has a high-risk association with vulval squamous cell carcinoma. Int J Gynecol Cancer. 2009;19(4):741–4.

    PubMed  Google Scholar 

  145. Eva LJ, et al. Vulval squamous cell carcinoma occurring on a background of differentiated vulval intraepithelial neoplasia is more likely to recur: a review of 154 cases. J Reprod Med. 2008;53(6):397–401.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Deborah DeLair M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

DeLair, D. (2013). Pathology of Gynecologic Cancer. In: Lichtman, S., Audisio, R. (eds) Management of Gynecological Cancers in Older Women. Springer, London. https://doi.org/10.1007/978-1-4471-4605-6_2

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4605-6_2

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2215-9

  • Online ISBN: 978-1-4471-4605-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics