Endometrial Gastric-type Carcinoma: An Aggressive and Morphologically Heterogenous New Histotype Arising From Gastric Metaplasia of the Endometrium.

Abstract

In Reply: We thank Travaglino and colleagues for their comments on our study and their description of an additional case of endometrial gastric-type carcinoma.1 We read with interest the points raised by Travaglino and colleagues regarding the morphologic heterogeneity of this tumor type and the possible precursor lesions and would like to supplement their correspondence by reporting another case, which similarly demonstrates the broad morphologic spectrum that may be encountered. With the scarcity of published cases, it is important to document further examples of endometrial gastric-type adenocarcinomas, especially those with previously unpublished features. Our case was recently encountered in consultation by one of us (W.G.M.). The patient was a 48-year-old woman who underwent hysterectomy, bilateral salpingectomy, and left oophorectomy 4 years earlier. The uterine corpus contained a deeply myoinvasive tumor with prominent lymphovascular invasion and no cervical involvement in the section sampled (the cervix was not completely submitted). No adnexal involvement was seen; the tumor was FIGO stage IB. The tumor contained “well-differentiated” areas featuring widely spaced glands with abundant clear or eosinophilic cytoplasm, as well as solid, poorly differentiated areas. There were foci