Evanescence of Endometrial Carcinomas in Hysterectomy Specimens: Observations on the “Vanishing Cancer” Phenomenon

Abstract

Background. The phenomenon of vanishing carcinomas, first described in context of prostatic carcinomas, has been documented in endometrial carcinomas as well. Methods. The archives of the department were searched for case files of endometrial carcinoma diagnosed on endometrial curetting/biopsy but which did not reveal any cancer on the subsequent hysterectomy specimen. Clinical and pathological correlation was established. Results. A total of 5 cases were retrieved with biopsy-diagnosed endometrial carcinomas, 4 endometrioid and 1 serous type, which on subsequent hysterectomies did not reveal any tumor. These 5 cases represented 1.56% of total hysterectomies in our series. All were Stage Ia tumors, which on follow-up (mean = 18.2 months) did not show any local reoccurrence. Adjuvant therapy was instituted in 1 case in the form of pelvic irradiation in view of the serous histology. In all cases, the primary diagnosis was reconfirmed and any remote possibility of incorrect patient identification, laboratory errors, and institution of hormonal therapy were adequately ruled out along with an extensive endometrial sampling in hysterectomy. Conclusion. The recognition of “vanishing endometrial carcinoma” as a distinct entity is of utmost importance to avoid mislabeling them as medical errors.