Background: Uterine papillary serous adenocarcinoma (UPSA) is a highly aggressive neoplasm with a great tendency for dissemination. p53 and c-erbB-2 immunoreactivity and DNA ploidy are considered to be indicators of prognosis for endometrial carcinomas.
Methods: Ten cases of patients with UPSA are reported. An attempt to relate pathologic findings with immunohistochemical stains for p53- and c-erbB-2-associated proteins, ploidy, and survival was made.
Results: Three patients were classified as having Stage I; three, Stage II; two, Stage III; and two, Stage IV. Myometrial invasion was present with nine tumors and involved over 50% of the myometrial thickness in five. Uterine lymph vessel invasion was detected in seven cases. Peritoneal spread occurred in six patients. Overexpression of p53 was observed in six tumors, immunoreactivity for c-erbB-2 in four, and aneuploidy in seven. However, only peritoneal spread correlated significantly with survival (P < 0.005).
Conclusions: UPSA is a tumor with a high metastatic potential that exhibits immunoreactivity for p53 and c-erbB-2 and aneuploidy more often than that reported for conventional endometrioid adenocarcinomas.