64-year-old female diagnosed with High Grade Endometrial Carcinoma.
• Findings Histopathology confirmed pT1b pN0 disease (FIGO Stage II C), favoring dedifferentiated carcinoma with
>50% myometrial invasion.Bilateral pelvic lymph nodes, retroperitoneal lymph nodes, and omentum free of
metastatic involvement ; focal LVSI identified.
• Initial treatment: Underwent definitive surgical management consisting of total abdominal hysterectomy + bilateral
salpingo-oophorectomy, bilateral pelvic lymph node dissection, retroperitoneal lymph node sampling, and
omentectomy, achieving complete macroscopic tumor resection.
• Further evaluation: Targeted NGS Panel (OncoIndx 360) was performed on FFPE tissue to identify
prognostic/predictive markers, enabling molecular risk stratification and adjuvant therapy decisions.
Clinical Challenges
• Aggressive histologic features appeared disproportionate to anatomic staging, raising concern that surgical clearance might not
fully represent underlying biological behavior.
• Stage II node-negative disease with myometrial invasion and focal LVSI created uncertainity regarding the need for adjuvant
therapy.
• Identification of a TP53 mutation was critical, as molecular subtype in early-stage endometrial carcinoma directly determines
escalation or de-escalation of adjuvant therapyx