Serous Carcinoma in Endometrial Polyps

Sixteen patients who had serous carcinoma involving endometrial polyps and who demonstrated rare or absent myometrial or lymphovascular invasion are reported. Six of these patients had clinical manifestations of extrauterine disease at presentation. Of the ten patients who presented with clinical stage I disease, six eventually developed extrauterine recurrence, and four of these six were dead of disease within 19 mo of recurrence. Similarities between the patients who presented with extrauterine disease and the patients who presented with clinical stage I disease, including high percentages of patients with hyperplasia of ovarian epithelium surface and of fallopian tube epithelium, suggest that serous carcinoma involving endometrial polyps may represent one aspect of a multicentric disease. In such multicentricity, the entire female genital tract and the abdominal peritoneal surfaces would be at high risk for concurrent or subsequent involvement by serous carcinoma even in the absence of myometrial or lymphovascular invasion.