Metastatic uterine serous carcinoma originating in an endometrial polyp: a report of 2 cases

BACKGROUND: Endometrial carcinoma is the most common cancer of the female genital tract. Two histologic variants have been described: an estrogen-dependent form and a more aggressive, non-estrogen-dependent form, which includes uterine serous carcinoma. CASES: Two cases of uterine serous carcinoma were confined to an endometrial polyp without myometrial invasion and were widely metastatic. One patient presented with abdominal pain and constipation, while the other patient was asymptomatic. Both patients had elevated CA-125 levels. At the time of surgery, these patients were found to have extensive carcinomatosis and underwent surgical staging procedures that required bowel resections. Pathology showed metastatic disease originating in a small focus of serous adenocarcinoma at the tip of an endometrial polyp. Combination chemotherapy was planned; but 1 of the patients died prior to its initiation. CONCLUSION: These cases emphasize the aggressive nature of uterine serous carcinoma despite insignificant myometrial invasion.