HPV11 Positive Endometrioid Carcinoma of the Endometrium with Signet-Ring Cells: Diagnostic Criteria and Review of the Literature

The presence of signet-ring cells in an endometrial adenocarcinoma is extremely uncommon and it is always necessary to rule out a metastatic neoplasm. We report a FIGO grade 2 endometrial carcinoma with a signet-ring cell component found in the curettage performed to a 53-year-old woman. The neoplastic proliferation was also found in the endometrium of the radical hysterectomy with bilateral salpingo-oophorectomy and pelvic and para-aortic lymphadenectomy. The uterine neoplasm invaded less than one-half of the myometrium (FIGO stage I B). Alcian blue showed the presence of mucin in the signet-ring cells. The patient was alive and without evidence of recurrence 14 months after surgery. Polymerase chain reaction method from paraffin-embedded tissue revealed the presence of human papilloma virus type 11. We have discussed the differential diagnosis of this kind of neoplasm and we have reviewed the literature on signet-ring cell carcinoma of the endometrium.