Subclassification of ovarian and endometrial carcinoma based on tumor cell type, i.e. histotype has been done for more than 50 years. While the same histotypes are encountered in ovarian carcinoma and endometrial carcinoma (serous, endometrioid, clear cell, mucinous), the past 15 years has seen a dramatic divergence between how we approach diagnosis of ovarian and endometrial carcinoma. In ovarian carcinoma the histotypes reflect the underlying genetic abnormalities; homologous recombination deficiency is a feature of high-grade serous carcinoma, for example, while mismatch repair deficiency is seen in endometrioid and clear cell carcinomas. In contrast, the histotypes of endometrial carcinoma imperfectly reflect the underlying molecular abnormalities, so that molecular subtypes are becoming important in guiding treatment. In this presentation the divergent evolution of ovarian and endometrial carcinoma histotype diagnosis will be charted, with discussion of the differences between ovarian and endometrial carcinoma and how they impact on surgical pathology practice and patient care in 2022.
At the end of this session participants will be able to:
- Identify the five histotypes of ovarian carcinoma and understand how they impact on patient management
- Describe how histotype diagnosis of endometrial carcinoma has not performed as well as ovarian carcinoma histotype diagnosis in guiding patient care