Glassy Cell Carcinoma of the Endometrium Presenting as an Intracavitary Leiomyoma on Ultrasound

Patient: Female, 58 Final Diagnosis: Endometrial poorly differentiated adenosquamous carcinoma • glassy cell carcinoma tumor Symptoms: Postmenopausal spotting Medication: — Clinical Procedure: Endometrial biopsy then robotic total hysterectomy • bilateral salpingooophrectomy • pelvic lymph node mapping and bilateral pelvic lymphadenectomy Specialty: Obstetrics and Gynecology OBJECTIVE: Rare co-existance of disease or pathology BACKGROUND: Glassy cell carcinoma of the endometrium is an extremely rare variant of adenosquamous carcinoma, and it has a poor prognosis. In postmenopausal women it typically presents as unprovoked, painless uterine bleeding. Tissue sampling is necessary to establish the diagnosis. CASE REPORT: A 58-year-old postmenopausal woman on no hormone replacement therapy experienced 2 months of intermittent uterine bleeding. An office transvaginal ultrasound discovered a 1.7-cm intracavitary leiomyoma, but because the endometrial stripe was not visualized, an endometrial biopsy was performed. She was found to have a Stage 1 A endometrial poorly-differentiated adenosquamous carcinoma, glassy cell carcinoma tumor of 1.5 cm in greatest dimension. She underwent a robotic total hysterectomy, bilateral salpingo-oophorectomy, pelvic lymph node mapping, and bilateral pelvic lymphadenectomy. CONCLUSIONS: Glassy cell carcinoma of the endometrium can present as an intracavitary leiomyoma in postmenopausal women.