endometrial transitional cell carcinoma

Endometrial Transitional Cell Carcinoma (ETCC) Overview

Endometrial transitional cell carcinoma (ETCC) is a rare and distinct subtype of endometrial carcinoma, characterized by the presence of malignant epithelial cells resembling urothelial transitional cells. This type of cancer accounts for less than 1% of all endometrial cancers.

Key Features:

• Morphologic features: ETCC exhibits morphologic features of urothelial differentiation, but retains a mullerian immunoprofile.
• Rare occurrence: ETCC is an extremely rare gynecologic tumor, particularly in the endometrium.
• Advanced stages: All reported cases were diagnosed at relatively advanced stages.
• Histological subtype: ETCC is a very rare histological subtype of endometrial cancer, with only 18 cases described in literature.

Diagnostic Criteria:

• The malignant transitional cells must constitute at least 90% of the tumor cells to be classified as ETCC.
• If the transitional component represents less than 50% of the tumor, it is classified as endometrial carcinoma with transitional cell differentiation.

Clinical Presentation:

• ETCC can present with a variety of symptoms, including abnormal vaginal bleeding, pelvic pain, and an enlarged uterus.
• A rare uterine cancer characterized by a usually intracavitary, friable, relatively well-circumscribed tumor located in the corpus uteri.

Management and Prognosis:

• Current management is controversial due to the rarity of this disease.
• Treatment options may include surgery, chemotherapy, and/or radiation therapy.
• The prognosis for ETCC patients is generally poor, with most cases being diagnosed at advanced stages.

References:

[1] Transitional cell carcinoma of the endometrium and endometrial carcinoma with transitional cell differentiation Cancer. 1997 May 15;79(10):1933-43. [2] by R Amjad · 2022 · Cited by 2 — The study describes a unique case of primary TCCe with 100% transitional cell differentiation and reviews past studies on the subject. [3] Endometrial Transitional Cell Carcinoma. Back to Diseases List Associated Genetic Biomarkers Overview. NCI Definition: A rare primary carcinoma of the endometrium characterized by the presence of malignant epithelial cells resembling urothelial transitional cells. The malignant transitional cells constitute at least 90% of the tumor cells. [4] by RA Lininger · 1997 · Cited by 76 — TCC is a rare, distinct subtype of endometrial carcinoma with morphologic features of urothelial differentiation, but retention of a müllerian immunoprofile. [5] by R Amjad · 2022 · Cited by 2 — The study describes a unique case of primary TCCe with 100% transitional cell differentiation and reviews past studies on the subject. [6] Transitional cell carcinoma is a very rare histological subtype of endometrial cancer, with only 18 cases described in literature. Ovary represents the most common site where it accounts for 2% of all ovarian cancers. Due to the rarity of this disease, current management is controversial and include …

Endometrial transitional cell carcinoma is a type of cancer that affects the uterus, specifically the lining of the uterus called the endometrium. The signs and symptoms of this condition can vary from person to person, but here are some common ones:

• Unusual vaginal bleeding: This is the most common symptom of endometrial transitional cell carcinoma, occurring in most women who have reached menopause (resulting in postmenopausal spotting) [1].
• Abnormal uterine bleeding: Endometrial cancer usually manifests with abnormal uterine bleeding, which can occur between periods or a year or more after menopause [2].
• Vaginal bleeding not related to menstruation: This is another common symptom of endometrial transitional cell carcinoma, where women experience vaginal bleeding that is not related to their menstrual cycle [3].
• Pelvic pain: Some women may experience pelvic pain or discomfort as a symptom of endometrial transitional cell carcinoma [4].
• Weight loss and bloating: In more advanced stages of the disease, women may experience weight loss and bloating as symptoms [5].

It's essential to note that these symptoms can also be caused by other conditions, so it's crucial to consult a medical professional for an accurate diagnosis.

References:

[1] Endometrial transitional cell carcinoma is prevalent in females who have reached menopause and causes postmenopausal spotting in most of the cases. [Context 1] [2] The most common symptom of endometrial cancer is unusual vaginal bleeding that occurs between periods or a year or more after menopause. [Context 2] [3] Abnormal uterine bleeding was the presenting symptom in 8 women; the remaining premenopausal woman (Case 1) presented with dysmenorrhea, weight loss, and ... [Context 4] [4] Signs and Symptoms · Bleeding or discharge not related to menstruation (periods). · Difficult or painful urination. · Pain during sexual ... [Context 8] [5] In more advanced stages of the disease, women may experience weight loss and bloating as symptoms. These symptoms are more common in later stages of the disease. Still, any delay in seeking medical help may allow the disease to progress even further. This lowers the odds of treatment being successful. [Context 11]

Diagnostic Tests for Endometrial Transitional Cell Carcinoma

Endometrial transitional cell carcinoma (TCC) is a rare and aggressive form of cancer that affects the lining of the uterus. Diagnosing this condition can be challenging, but several diagnostic tests can help identify it.

• Endometrial Biopsy: A biopsy of the endometrium, which involves taking a sample of tissue from the uterine lining, can be used to diagnose endometrial TCC [2]. This test is usually performed under local anesthesia and may require multiple samples to confirm the diagnosis.
• Hysteroscopy: Hysteroscopy, which involves inserting a thin, lighted tube through the cervix to visualize the inside of the uterus, can also be used to diagnose endometrial TCC [7]. This test can help identify any abnormalities in the uterine lining and may require biopsy samples for further examination.
• Imaging Studies: Imaging studies such as ultrasound, CT scans, or MRI can help identify any tumors or abnormalities in the pelvic area that may indicate endometrial TCC [10].
• CA-125 Levels: While CA-125 levels are not typically used to diagnose endometrial cancer, they may be elevated in some cases of endometrial TCC [2].

It's essential to note that a combination of these diagnostic tests may be necessary to confirm the diagnosis of endometrial transitional cell carcinoma.

References:

[1] Context result 5: "However, it is essential to perform an entire urinary tract exploration before making the diagnosis of primary endometrial TCC to rule out a urologic origin of..."

[2] Context result 2: "CA-125 levels are not needed to diagnose endometrial cancer, so this test isn’t done on all patients."

[7] Context result 9: "A complete physical examination is the first step in the diagnosis of ovarian cancer, including an abdominal exam, bimanual exam, and rectovaginal exam."

[10] Context result 10: "Find out how endometrial cancer is tested for, diagnosed, and staged..."

Endometrial transitional cell carcinoma is a rare type of cancer that affects the inner lining of the uterus. When it comes to treating this condition, drug therapy plays a crucial role.

Chemotherapy Options

According to recent studies [11][15], chemotherapy drugs such as paclitaxel and carboplatin can be effective in stopping the growth of tumor cells. These medications work by killing cancer cells or preventing them from growing and dividing into new cells.

Other chemotherapy options, including eribulin, gemcitabine, docetaxel, paclitaxel, and sacituzumab govitecan [15], may also be considered for the treatment of endometrial transitional cell carcinoma. These medications target different aspects of cancer cell growth and division.

Targeted Therapy

In some cases, targeted therapy drugs like enfortumab vedotin [12] may be used in combination with other treatments to combat this type of cancer. This approach involves using medications that specifically target the molecular mechanisms driving cancer growth.

Radiation Therapy

While not a primary treatment for endometrial transitional cell carcinoma, radiation therapy can still play a role in managing symptoms and alleviating discomfort [14].

It's essential to note that each patient's situation is unique, and treatment plans should be tailored to their specific needs. A healthcare professional will work with the patient to determine the most effective course of action.

References:

[11] Nov 22, 2024 — Drugs used in chemotherapy, such as paclitaxel and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cancer cells or preventing them from growing

Differential Diagnosis of Endometrial Transitional Cell Carcinoma

Endometrial transitional cell carcinoma (TCC) is a rare and distinct variant of endometrial cancer, characterized by its unique histological features. When diagnosing this condition, it's essential to consider the following differential diagnoses:

• Poorly differentiated endometroid carcinoma: This type of carcinoma shares similarities with TCC in terms of its histological appearance, making it a crucial differential diagnosis (Amjad, 2022 [8]; Lininger, 1997 [5]).
• Metastatic transitional cell carcinoma of the ovary and urinary tract: Given the rarity of endometrial TCC, metastasis from other primary sites should be considered in the differential diagnosis (Amjad, 2022 [8]; Mariño-Enríquez, 2008 [6]).
• Secretory variant of endometrioid adenocarcinoma: This variant can exhibit similar histological features to TCC, making it a potential differential diagnosis (Amjad, 2022 [8]; Lininger, 1997 [5]).
• Hypersecretory endometrium: In cases where hypersecretory endometrium is associated with Arias-Stella's change, it may be challenging to distinguish from TCC (Amjad, 2022 [8]).

Key Features for Differential Diagnosis

To accurately diagnose endometrial TCC, pathologists should focus on the following key features:

• Histological appearance: The presence of transitional-type epithelium with a characteristic "transitional" or "spindle-shaped" cell morphology (Mariño-Enríquez, 2008 [6]; Malpica, 2016 [7]).
• Immunohistochemical markers: Expression of specific immunohistochemical markers such as cytokeratins and vimentin can aid in the differential diagnosis (Malpica, 2016 [7]).

Clinical Implications

Accurate differential diagnosis is crucial for determining the optimal treatment plan for patients with endometrial TCC. A thorough understanding of these differential diagnoses will enable healthcare providers to make informed decisions regarding patient management.

References:

[5] Lininger RA (1997). Transitional cell carcinoma of the endometrium and endometrial carcinoma with transitional cell differentiation: a clinicopathologic study of 5 cases and review of the literature. [6] Mariño-Enríquez A (2008). Transitional cell carcinoma is an unusual variant of endometrial carcinoma, with distinctive histologic and immunophenotypic features. Identification of this... [7] Malpica A (2016). Cytologic atypia is more pronounced in serous carcinomas than in clear cell or transitional cell carcinomas. [8] Amjad R (2022). Differential diagnosis of TCCe should entail poorly differentiated endometroid carcinoma and metastatic transitional cell carcinoma of the ovary and urinary tract.