Analysis of mixed type endometrial carcinoma

Objective: To analyze local surgical-pathological factors of mixed type endometrial carcinoma and to examine their relationship with cell types. Material and Methods: Data of 33 cases, definitely diagnosed with mixed type endometrial carcinoma between January 1993 and May 2013, were examined retrospectively. Results: Of 1640 patients diagnosed with endometrial carcinoma and received treatment, 33 (2%) had mixed cell type. Average age of the study group was 60 years. According to the FIGO 2009 staging, 18 patients were stage I. Tumors were composed of endometrioid and serous components in 5 cases (15.2%), endometrioid and clear cell components in 12 cases (36.4%), endometrioid and mucinous components in 12 cases (36.4%) and serous and clear cell components in 4 cases (12.1%). In 21 cases (63.6%) at least one of the serous and clear cell components was present. The presence of lymph node metastasis was noticed only in cases composed of serous or clear cell type of endometrial carcinoma (p=0.041). Other surgical-pathological factors such as age, tumor size, grade, presence and depth of myometrial invasion, cervical and lymphovascular area invasion, adnexal involvement, peritoneal cytology, the number of lymph nodes removed and were statistically similar among cases with different cell types. Median follow-up time was 24 months. Within follow-up period, two cases were presented with recurrence of carcinoma and one case was presented with progression during adjuvant treatment. Two of 3 cases had aggressive cell type and were staged as IV-B with lymph node metastasis. Other case had cervical invasion and tumor was composed of mucinous and endometrioid cell type. Conclusion: Clear cell or serous component of tumor determined lymph node metastasis which is an important prognostic factor in terms of survival