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Peer-reviewedCC BYCureus

Endometrial Giant Cell Carcinoma Integrating Morphology, Immunophenotype, and Molecular Findings in a Misdiagnosed Case.

  • Omar Y Alfaqih1
  • Sahar B Mehecy2
  • Mohammed Abdelatif M Elhassan1
  1. 1Anatomical Pathology, King Fahad Medical City, Riyadh, SAU.
  2. 2Histopathology, Sudan Medical Specialization Board, Khartoum, SDN.
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Abstract

Endometrial giant cell carcinoma (EGCC) is an exceptionally rare and diagnostically challenging variant of high-grade endometrial carcinoma. We describe the case of a 60-year-old postmenopausal woman who was initially misdiagnosed with carcinosarcoma on endometrial curettage. Histopathologic review, immunohistochemical analysis, and comprehensive molecular profiling identified pathogenic tumor protein p53 (TP53), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), and AT-rich interaction domain 1A (ARID1A) mutations, supporting the diagnosis of EGCC and its classification within the p53-abnormal (copy-number-high) molecular subtype of The Cancer Genome Atlas (TCGA). The patient subsequently underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and bilateral pelvic lymphadenectomy, which revealed no residual carcinoma and no nodal metastasis. Long-term follow-up was unavailable because the patient missed all surveillance visits, preventing any assessment of prognosis. This report underscores the importance of integrating morphologic, immunophenotypic, and molecular findings to distinguish EGCC from carcinosarcoma and other giant cell-rich uterine tumors, an approach that is essential for accurate diagnosis and for guiding individualized management of these malignancies.

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Cite

BibTeXRIS
BibTeX
@article{alfaqih2026endometrial,
  title = {{Endometrial Giant Cell Carcinoma Integrating Morphology, Immunophenotype, and Molecular Findings in a Misdiagnosed Case.}},
  author = {Omar Y Alfaqih and Sahar B Mehecy and Mohammed Abdelatif M Elhassan},
  journal = {Cureus},
  year = {2026},
  month = sep,
  doi = {10.7759/cureus.117050},
  url = {https://europepmc.org/article/MED/42953083},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Endometrial Giant Cell Carcinoma Integrating Morphology, Immunophenotype, and Molecular Findings in a Misdiagnosed Case.
AU  - Omar Y Alfaqih
AU  - Sahar B Mehecy
AU  - Mohammed Abdelatif M Elhassan
PY  - 2026
DA  - 2026/09/28
JO  - Cureus
DO  - 10.7759/cureus.117050
UR  - https://europepmc.org/article/MED/42953083
AB  - Endometrial giant cell carcinoma (EGCC) is an exceptionally rare and diagnostically challenging variant of high-grade endometrial carcinoma. We describe the case of a 60-year-old postmenopausal woman who was initially misdiagnosed with carcinosarcoma on endometrial curettage. Histopathologic review, immunohistochemical analysis, and comprehensive molecular profiling identified pathogenic tumor protein p53 (TP53), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), and AT-rich interaction domain 1A (ARID1A) mutations, supporting the diagnosis of EGCC and its classification within the p53-abnormal (copy-number-high) molecular subtype of The Cancer Genome Atlas (TCGA). The patient subsequently underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and bilateral pelvic lymphadenectomy, which revealed no residual carcinoma and no nodal metastasis. Long-term follow-up was unavailable because the patient missed all surveillance visits, preventing any assessment of prognosis. This report underscores the importance of integrating morphologic, immunophenotypic, and molecular findings to distinguish EGCC from carcinosarcoma and other giant cell-rich uterine tumors, an approach that is essential for accurate diagnosis and for guiding individualized management of these malignancies.
SN  - 2168-8184
ER  -