Sex Cord–like Endometrioid Carcinoma Arising From Broad Ligament, a Challenging Diagnosis: Report of 2 Cases

Saikat Mitra, Ajay Mandal, Amit Mandal
In: International Journal of Gynecological Pathology · 2025 · vol. 45(2) , pp. 175–180 · doi:10.1097/pgp.0000000000001124 · PMID:41161696 · W4415680382
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⚙ AI-generated summary by claude@2026-07, 2026-07-29 ⓘ

This report describes two challenging cases of primary sex cord–like endometrioid carcinoma arising from the broad ligament, requiring extensive histologic and immunohistochemical evaluation for diagnosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-14 · read from full text ⓘ

This paper reports two rare cases of sex cord–like endometrioid carcinoma (SCLEC) arising from the broad ligament in women aged 62 and 47, both presenting with abdominal pain and abnormal uterine bleeding in one case; imaging in each case suggested a broad-ligament fibroid. Histology showed a sex cord–like pattern with only rare foci of conventional endometrioid carcinoma, and immunohistochemistry revealed positivity for CK-7, EMA, ER, PR, CDX-2, CD-10, and nuclear β-catenin, with multiple other markers negative, leading to diagnosis of primary broad ligament SCLEC. The main caveat emphasized is that the diagnosis is “extremely challenging” and requires thorough histologic and immunohistochemical evaluation to exclude differential diagnoses. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Endometrioid carcinoma is a common malignant epithelial tumor of the uterus and ovary, exhibiting variable histomorphology and immunophenotype. Sex cord-like endometrioid carcinoma (SCLEC) is a rare histologic subtype with significant morphologic and immunohistochemical variability. Extra-ovarian, extra-uterine SCLEC arising from the broad ligament has been rarely reported. We report 2 cases of SCLEC arising from the broad ligament. The first patient, a 62-yr-old woman, presented with vague abdominal pain, and diagnostic imaging suggested a broad ligament fibroid. The second patient, a 47-yr-old woman, presented with a clinical history of abdominal pain and abnormal uterine bleeding. Diagnostic imaging suggested a subserosal fibroid. Histologic evaluation revealed a sex cord-like pattern with only rare foci of conventional endometrioid carcinoma. Immunohistochemical evaluation of both cases showed positivity for CK-7, EMA, ER, PR, CDX-2, CD-10, and nuclear β-catenin, while CK-20, PAX-8, GATA3, TTF-1, WT-1, napsin-A, p16, p53, inhibin, calretinin, chromogranin, and CEA were negative. The diagnosis of primary broad ligament SCLEC is extremely challenging. A thorough histologic and immunohistochemical evaluation is essential before excluding differential diagnoses.
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Endometrioid carcinoma is a common malignant epithelial tumor of the uterus and ovary, exhibiting variable histomorphology and immunophenotype. Sex cord–like endometrioid carcinoma (SCLEC) is a rare histologic subtype with significant morphologic and immunohistochemical variability. Extra-ovarian, extra-uterine SCLEC arising from the broad ligament has been rarely reported. We report 2 cases of SCLEC arising from the broad ligament. The first patient, a 62-yr-old woman, presented with vague abdominal pain, and diagnostic imaging suggested a broad ligament fibroid. The second patient, a 47-yr-old woman, presented with a clinical history of abdominal pain and abnormal uterine bleeding. Diagnostic imaging suggested a subserosal fibroid. Histologic evaluation revealed a sex cord–like pattern with only rare foci of conventional endometrioid carcinoma. Immunohistochemical evaluation of both cases showed positivity for CK-7, EMA, ER, PR, CDX-2, CD-10, and nuclear β-catenin, while CK-20, PAX-8, GATA3, TTF-1, WT-1, napsin-A, p16, p53, inhibin, calretinin, chromogranin, and CEA were negative. The diagnosis of primary broad ligament SCLEC is extremely challenging. A thorough histologic and immunohistochemical evaluation is essential before excluding differential diagnoses. Sex Cord–like Endometrioid Carcinoma Arising From Broad Ligament, a Challenging Diagnosis: Report of 2 Cases Plain Language SummarySex cord–like endometrioid carcinoma (SCLEC) is a rare type of tumor that can occur outside the uterus and ovaries, such as in the broad ligament. This study reports two cases of SCLEC in the broad ligament, highlighting the diagnostic challenges due to its unusual presentation. Both patients, women aged 62 and 47, experienced abdominal pain and were initially thought to have fibroids based on imaging. Detailed histological and immunohistochemical analysis revealed SCLEC, showing positivity for markers such as CK-7, EMA, ER, PR, CDX-2, CD-10, and nuclear β-catenin, while other markers were negative. Accurate diagnosis requires comprehensive evaluation to differentiate SCLEC from other conditions, emphasizing the complexity of identifying this rare tumor. Text is machine generated and may contain inaccuracies. FAQ

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