Two clinical cases of endometrial cancer with the same clinical presentation but different disease outcomes

Objective: to improve the methods of pathomorphological and molecular-genetic diagnosis of endometrial cancer for risk group stratification.

Material and methods: a retrospective analysis of two clinical cases of endometrial cancer treated at the State Institution “Republican Oncology Scientific Center” of the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan was conducted. Clinical, laboratory, and imaging diagnostic methods were used. Pathomorphological verification and immunohistochemical (IHC) analysis were carried out on surgical specimens.

Results: patient No. 1 and Patient No. 2 had the same clinical picture but different pathomorphological and moleculargenetic characteristics, which led to different disease outcomes. Patient No. 1, presenting with infiltrative endometrioidtype endometrial adenocarcinoma, G1 (low grade), myometrial invasion of less than 50%, and an MMRd molecular subtype (FIGO 2023 stage IA2), is currently healthy with no evidence of recurrence. Patient No. 2, presenting with infiltrative serous-type endometrial adenocarcinoma, G3 (high grade), myometrial invasion of more than 50%, and a p53abn molecular subtype (FIGO 2023 stage IIC), died 2 years after the initial diagnosis.

Conclusions: early surgical treatment combined with comprehensive pathological and molecular genetic evaluation allows for optimization of diagnostic accuracy and personalized management of patients with endometrial cancer, thereby improving survival outcomes and quality of life.

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