Primary intestinal type endometrial mucinous carcinoma: a case report and review of the literature

Primary gastric (gastrointestinal) mucinous carcinoma of the endometrium is a newly defined entity in the latest WHO classification. It is known to have an aggressive clinical course compared to conventional mucinous endometrial carcinomas. The case we present is a 65-year-old female patient. The patient underwent total abdominal hysterectomy, bilateral salpingooophorectomy, bilateral pelvic and para-aortic lymph node dissection, and omentectomy. Histologically, the tumor contains enterocyte-like cells with a brush border, as well as abundant eosinophilic cytoplasm with mild or moderate atypia and occasional goblet cells. In immunohistochemical evaluation, CK7, CK20, CDX2, Villin, and CEA was positive in the tumor. The patient was diagnosed as primary intestinal type mucinous endometrial carcinoma based on morphological and immunohistochemical findings. The patient’s molecular examination revealed mutations in the TP53, RB, and FBXW7 genes. The patient has been followed up for 6 months without disease after receiving 6 cycles of chemotherapy. The clinical, histopathological, immunohistochemical, and molecular features of the case were described, and the literature was reviewed. The recognition and differential diagnosis of this rare tumor will contribute to appropriate patient management and accurate prognostication.