Molecular genetics of uterine malignancies

The second major group of endometrial carcinomasType II carcinomas-generally have a poorer prognosis, appear unrelated to estrogenic stimulation, are of higher grade and stage, and manifest at a later age. The majority of Type II tumors are histologically classified as serous carcinoma, showing striking nuclear atypia and either a glandular or papillary architecture (8). The serous cancers of the endometrium usually appear on an atrophic endometrium, and it has recently been proposed that they arise from a histologically recognizable precursor referred to as endometrial intraepithelial carcinoma (9). This distinguishes them from the endometrioid tumors, which are often seen on hyperplastic endometrium. It is important to note that not all Type II tumors are uterine papillary serous carcinomas. There are other histologic variants including clear cell, mucinous, and other carcinomas that are potentially under-diagnosed because of lack of familiarity with these uncommon subtypes.