Subtle Intrusion: Minimal Serous Uterine Carcinoma in an Asymptomatic Postmenopausal Patient-A Case Report.

Abstract

Introduction: Minimal serous uterine cancers (MUSCs) represent a distinct subset of endometrial malignancies characterized by early-stage presentation and unique histopathological features. These tumors typically manifest as intraepithelial or superficial serous carcinomas confined to endometrial polyps without myometrial invasion or lymphovascular involvement. MUSCs are predominantly diagnosed in postmenopausal women and are associated with favorable prognosis.

Case presentation: The present case report briefs the finding of a 60-year-old woman presenting to the gynecological outpatient department for a routine gynaecological check-up. She was a known case of type II diabetes mellitus, hypertension, and asthma. She had no history of postmenopausal bleeding or vaginal discharge. Incidentally, on per speculum examination, a polyp of 2x3 cm was seen protruding through the cervical opening (cervical os). Her transvaginal ultrasound revealed a postmenopausal uterus with a thickened endometrium of 10mm. Her histopathology report of dilatation and curettage with polypectomy revealed serous carcinoma against the background of atrophic endometrium. The patient was managed with staging laparotomy with Wertheim's hysterectomy with bilateral pelvic lymph node dissection, omentectomy, and parietal peritoneum biopsy. Her final histopathology report revealed Stage 1A1 MUSC with atrophic endometrium.

Conclusion: The case report highlights the clinical significance of recognizing MUSC as an early- stage variant of endometrial cancer. Postmenopausal women, vulnerable to uterine serous carcinoma, require comprehensive sampling of all endometrial biopsies, curettings, and endometrial polyps to ensure early detection and accurate staging.