Uterine Perivascular Epithelioid Cell Tumor Diagnostic Differences Between Endometrial Curettage Material and Resection Material and Histopathological and Immunohistochemical Approach to the Difficulties in Differential Diagnosis

Year 2021, , 309 - 313, 01.09.2021

Büşra Erşan Erdem , Havva Erdem

https://doi.org/10.19127/bshealthscience.922813

Abstract

Uterine perivascular epithelioid cell tumor is a rare mesenchymal tumor consisting of histologically and immunohistochemically distinctive perivascular epithelioid cells. These tumors’ being rare, having different morphological features and having similar immunohistochemical expression findings to that of some tumors lead to diagnostic difficulties and misdiagnoses. In the present case report, we aimed to discuss the traps we fell into while diagnosing the curettage material as neuroendocrine tumor and how we have been directed to the diagnosis of perivascular epithelioid cell tumor, as well as to discuss what to be taken into account while making the differential diagnosis under the guidance of the literature.

Keywords

PEComa, Perivascular epithelioid cell tumors, Uterus, Neuroendocrine tumor, Endometrial polyp

References

• Albores-Saavedra J, Dorantes-Heredia R, Chablé-Montero F, Chanona-Vilchis J, Pérez-Montiel D, Lino-Silva LS, González-Romo MA, Ramírez-Jaramillo JM, Henson DE. 2014. Endometrial stromal sarcomas: immunoprofile with emphasis on HMB45 reactivity. American J Clin Pathol, 141(6): 850-855.
• Baker P, Oliva E. 2007. Endometrial stromal tumours of the uterus: a practical approach using conventional morphology and ancillary techniques. J Clin Pathol, 60(3): 235-243.
• Bennett JA, Braga AC, Pinto A, Van de Vijver K, Cornejo K, Pesci A, Zhang L, Morales-Oyarvide V, Kiyokawa T, Zannoni GF, Carlson J, Slavik T, Tornos C, Antonescu CR, Oliva E. 2018. Uterine PEComas: A Morphologic, Immunohistochemical, and Molecular Analysis of 32 tumors. The American J Surg Pathol, 42(10): 1370-1383.
• Bonetti F, Pea M, Martignoni G, Zamboni G. 1992. PEC and sugar. The American J Surg Pathol, 16(3): 307-308.
• Fadare O. 2008. Perivascular epithelioid cell tumor (PEComa) of the uterus: an outcome-based clinicopathologic analysis of 41 reported cases. Advances in Anatomic Pathol, 15(2): 63-75.
• Fadare O, Liang SX. 2008. Epithelioid smooth muscle tumors of the uterus do not express CD1a: a potential immunohistochemical adjunct in their distinction from uterine perivascular epithelioid cell tumors. Annals of Diag Pathol, 12(6): 401-405.
• Ferenczi K, Lastra RR, Farkas T, Elenitsas R, Xu X, Roberts S, Brooks JS, Zhang PJ. 2012. MUM-1 expression differentiates tumors in the PEComa family from clear cell sarcoma and melanoma. Int J Surg Pathol, 20(1): 29-36.
• Folpe AL, Kwiatkowski DJ. 2010. Perivascular epithelioid cell neoplasms: pathology and pathogenesis. Human Pathol, 41(1): 1-15.
• Folpe AL, Mentzel T, Lehr HA, Fisher C, Balzer BL, Weiss SW. 2005. Perivascular epithelioid cell neoplasms of soft tissue and gynecologic origin: a clinicopathologic study of 26 cases and review of the literature. The American J Surg Pathol, 29(12): 1558-1575.
• Hong J, Wang K, Yu Y. 2018. Hepatobiliary and Pancreatic: Malignant pancreatic perivascular epithelioid cell tumor mimicking pancreatic neuroendocrine tumor. J Gastroenter and Hepatol, 33(12): 1940.
• Hornick JL, Fletcher CD. 2006. PEComa: what do we know so far? Histopathol, 48(1): 75-82.
• Lee CH, Ali RH, Rouzbahman M, Marino-Enriquez A, Zhu M, Guo X, Brunner AL, Chiang S, Leung S, Nelnyk N, Huntsman DG, Blake Gilks C, Nielsen TO, Dal Cin P, van de Rijn M, Oliva E, Fletcher JA, Nucci MR. 2012. Cyclin D1 as a diagnostic immunomarker for endometrial stromal sarcoma with YWHAE-FAM22 rearrangement. The American J Surg Pathol, 36(10): 1562-1570.
• Oliva E, Carcangiu ML, Carinelli SG. 2014. Mesenchymal tumors. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH, eds. WHO Classification of Tumours of Female Reproductive Organs. 4th ed. Lyon, France: IARC; 2014: 146-147.
• Wang X, Fu Y, Li B. 2018. Perivascular epithelioid cell tumor (PEComa) presents an endometrial polyp pattern: Case report and literature review. Human Pathol, 13: 66-68.
• Zhang S, Chen F, Huang X, Jiang Q, Zhao Y, Chen Y, Zhang J, Ma J, Yuan W, Xu Q, Zhao J, Wang C. 2017. Perivascular epithelial cell tumor (PEComa) of the pancreas: A case report and review of literature. Medicine, 96(22): e7050.