74y female diagnosed with metastatic endometrioid carcinoma.
• Findings: Total hysterectomy with BSO & B/L pelvic lymph nodes dissection. Histopathology revealed endometrioid
carcinoma of uterine corpus, FIGO GII; 3 left pelvic lymph nodes show metastatic carcinoma, FIGO stage IB,
pT1bpN1a. IHC shows endometrial tumor cells positive ER.PR.PAX and p16 patchy positivity, WT1, NapsinA, GATA 3
TTF1, Calretinin, CD10 were negative. SATB2 positive in squamous morules, Wild type p53, MMR protein deficient
(loss of expression of MLH1 & PMS2- MSI-H). Histopathology of right ovary Benign cystic Brenner tumor epithelial
cells positive for CK7,GATA 3and EMA.
• Further evaluation: Genomic profiling via OncoIndx 360 Tbx to identify actionable alterations and guide
personalized therapy.
Clinical Challenges
How should adjuvant treatment be tailored in node-positive disease with MMR deficiencyx