Endometrial giant cell carcinoma: a case report and review of the literature

Background: Endometrial giant cell carcinoma (EGCC) is a rare variant of endometrial carcinoma, and only two small series and few case reports have been described in the literatures. It has not been recognized as a separate entity in the current WHO classification of endometrial neoplasms. Data on the biological behavior, clinical management, and prognosis of EGCC are limited due to its rarity. Case presentation A 55-year-old postmenopausal woman presented with vaginal bleeding for about 2 months. Transvaginal ultrasound examination showed an echogenic polypoid mass measuring 1.8cm×1.2cm×1.6cm in the uterine cavity, a hysteroscopic lesion resection was performed. Histologically, in the background of multifocal necrosis, the tumor was remarkably composed of a large number of multinucleated giant cells and mononucleated cells, and a small part (10%) of the conventional EC components which exhibited mostly as serous carcinoma and focally as endometrioid differentiation scattered among them. In immunohistochemical staining, the tumor cells were strongly positive for EMA, P53(aberrant nuclear expression), Vimentin, molecular testing demonstrated p53-mutant subtype for molecular classification of EC. The pathological diagnosis was EGCC accompanied with serous carcinoma. The patient underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. The patient did not receive postoperative radiochemotherapy, and no evidence of disease was found after follow-up for 1 year. Conclusion EGCC is a rare type of uterine malignant tumor. It is necessary to realize this entity may be a rare variant of endometrial carcinoma, and the presence and/or percentage of giant cell component should be clearly notated in the pathology report, indicating that the biological behavior is unclear. Further experience for diagnose and treatment of this rare tumor is warranted.