The incidence of endometrial cancers diagnosed on biopsy that have no residual cancer identified at hysterectomy is not well studied. The aim of our study was to determine the incidence and long-term follow-up of this "vanishing cancer" phenomenon. All slides from the initial biopsy/curettage and hysterectomy specimens were reviewed and the diagnosis confirmed by a gynecologic pathologist. The entire endometrium was serially sectioned and submitted for histologic examination. Clinical and pathologic variables were analyzed, including patient demographics, tumor histologic type and grade, stage, biopsy method, adjuvant therapy, surgical procedure, recurrence, and disease-specific survival. We identified 23 biopsy-proven cases of endometrial cancer with no residual disease on hysterectomy specimen. Of the 23 patients, 15 (65.2%) were diagnosed as endometrioid, 6 (26%) serous, 1 clear cell (4.3%), and 1 (4.3%) serous intraepithelial carcinoma. Seventeen underwent dilatation and curettage, and 6 had endometrial biopsy as the primary procedure. The median follow-up was 8.8 years (range, 1.2 to 17 y). Only 2 cases with serous carcinoma underwent adjuvant chemotherapy, and none received radiation therapy. Only 1 patient died of disease after 27 months and was diagnosed as FIGO grade II endometrioid carcinoma on dilatation and curettage. The inability to identify cancer in a hysterectomy specimen for biopsy-confirmed carcinoma does not indicate technical failure. Although there is no specific standard treatment for patients with "vanishing endometrial cancer," the prognosis is excellent; however, close follow-up is suggested.
在活检标本中诊断为子宫内膜癌，但在子宫切除标本中没有发现残存癌肿的发生率尚未很好研究。本研究的目的在于确定这种“消失的癌”现象的发生率和长期随访情况。回顾研究了全部最初的活检/诊刮和子宫切除标本的切片，诊断经由一位妇科病理专家确认。全部子宫内膜连续切片，进行组织学检查。分析了临床和病理因素，包括患者的年龄、性别、肿瘤组织学类型和分级、分期、活检方法、辅助治疗、外科手术、复发以及生存期。有23例活检证实有子宫内膜癌，但在切除子宫未见残存癌。23例患者中，15例 (65.2%)诊断为子宫内膜样腺癌，6例 (26%)浆液性癌，1例透明细胞 癌(4.3%)，1例 (4.3%)浆液性上皮内癌。17例做过诊刮，6例最初做过子宫内膜活检。中位随访时间为8.8年 (1.2到17年)。只有2例浆液性腺癌做了辅助化疗，均未做过放疗。只有1例27个月后死于该疾病，诊刮诊断为 FIGO分期II级子宫内膜样癌。活检证实为癌，但切除子宫标本未见癌不能表明为技术上的失败。尽管对于“消失的子宫内膜癌”没有特定的治疗标准，该疾病的预后很好；但是，还需要密切随访。