Endometrial Papillary Adenocarcinomas

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Abstract
Thirty-four patients with primary endometrial papillary adenocar-cinoma diagnosed in our institution from 1970 to 1982 were studied. Papillary adenocarcinomas represented 10% of all endometrial adenocarcinomas seen during this period. Papillary neoplasms were morphologically subclassified as either papillary serous adenocarcinoma or welt-differentiated papillary adenocarcinoma, following review of the histological sections obtained prior to radiotherapy or chemotherapy. Twenty-five patients were found to have papillary serous adenocarcinoma, and nine had well-differentiated papillary adenocarcinoma. A control group of 305 patients with endometrial adenocarcinoma of nonpapillary type was compared with respect to age, race, and survival. Fifty percent of the patients with papillary serous adenocarcinoma were black and they were significantly older (p = 0.001) than the control group, with a mean age of 71 years. Thirty percent of the papillary serous adenocarcinoma group had deep myometrial invasion and peritoneal surface involvement by tumor. In 20% of these patients there was a discrepancy between the clinical stage and the surgical stage at laparotomy. Survival was markedly worse (p = 0.01) than that of the control group. Patients with well-differentiated papillary adenocarcinomas were similar to control patients with respect to age and racial status and had similar clinical survival outcome. We conclude that well-differentiated papillary adenocarcinoma of the endometrium is a distinct form of papillary adenocarcinoma, and must be morphologically and clinically distinguished from papillary serous adenocarcinomas because of its better prognosis. Morphological differentiation of these two papillary variants of endometrial adenocarcinoma is presented.

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