This audit focuses on homologous recombination deficiency (HRD) testing in patients with non-mucinous high-grade tubo-ovarian cancer, looking into the proportion of patients with positive HRD status, and investigating the possible factors leading to a failed/inconclusive test.
Poster 1: A Single Institution Experience of PTEN, PAX2 and B Catenin Immunostains in Gynaecological Pathology over a 1 Year Period
Use of PAX2, PTEN and Beta Catenin immunostains as diagnostic tool is of emerging interest in gynaecological pathology. Although recommended in the WHO 2020 Classification; the performance of these, especially in combination, have shown varying results.
Poster 2: Immunohistochemical Expression of PD-L1 in Surface Ovarian Epithelial Tumors; a TMA Study with Clinico-pathological Correlation
PD-L1 is expressed significantly in malignant tumours. Construction of a panel of IHC markers, including PD-L1, could be of value to define patients those might benefit from immunotherapy. TMA adequacy is better for malignant lesions, due to their wider surface areas, compared to borderline or benign counterparts.
Poster 3: Optimising Immunohistochemistry Reporting In Endometrial Cancer
Management of endometrial cancer involves a multidisciplinary team, with immunohistochemistry playing an important role. Introduction of a proforma was a successful intervention for improving reporting of immunohistochemistry, whilst maintaining a sustainable change in the management of endometrial cancer.
Poster 4: Mixed small cell carcinoma and squamous cell carcinoma of the cervix: A rare entity
Primary carcinoma admixed with neuroendocrine carcinoma in the female genital tract is a rare entity, with adenocarcinoma being the most common non-neuroendocrine component. Mixed squamous cell carcinoma and neuroendocrine carcinoma is even more rarely encountered. It is a clinically important malignancy to recognise because of its aggressiveness and grave prognosis, yet it could pose diagnostic challenge especially in cytology and small biopsy specimens, potentially delaying proper treatment. We report an interesting and rare case of mixed small cell carcinoma and squamous cell carcinoma of the cervix, first reported as glandular neoplasia in cytology and small cell carcinoma in biopsy, highlighting (1) the importance of extensive sampling in cervical tumours of unusual morphology, (2) the diagnostic dilemma and differential diagnoses of this rare entity, and (3) the practical diagnostic clues in distinguishing primary and metastatic tumours that could alter clinical management.
Poster 5: Primary Diffuse Large B cell Lymphoma of the Uterine Cervix – A Very Rare Disease
Primary DLBCL of the uterine cervix is a very rare disease, occurring in only 0.008% of cervical tumors. Diagnosis can be challenging. Treatment typically involves R-CHOP chemotherapy regimen. The prognosis is not well established, making a multi-disciplinary approach crucial.
Poster 6: Tubo-ovarian High Grade Serous Carcinoma with Low-grade Like Morphology: A Case Report
Tubo-ovarian high grade serous carcinoma with low-grade like morphology – An emerging entity.
Poster 7: Dedifferentiated Mucinous Ovarian Carcinoma: A Case Report and Literature Review
Dedifferentiated mucinous carcinoma of the ovary is a rare, highly aggressive and molecularly distinct ovarian malignancy characterised by frequent inactivation of core SWI/SNF complex and typically a low response rate to platinum based-standard care for ovarian cancer.
Poster 8: Impact of the 2023 FIGO Staging System in Endometrial Cancer Patients
The new 2023 FIGO resulted in stage shifts for nearly 20% of patients. Additionally, it strongly discriminated prognosis in early stage.
Poster 9: Endometrial Sampling in Radical Hysterectomies for Malignant and Borderline Tubo-ovarian Malignancies
Neither RCPath nor CAP guidelines address endometrial sampling in tubo-ovarian malignancies(1,2). The FIGO/TNM staging systems do not include endometrial involvement by tubo-ovarian malignancies. 1-2 blocks are sufficient from macroscopically normal endometrium. Additional endometrial sampling offers no added benefit but has cost and workload implications.
Poster 10: Poster removed from display
Poster 11: Epithelioid Trophoblastic Tumour: Diagnostic Challenges of Unusual Morphology
A case of epithelioid trophoblastic tumour showing some unusual morphological features, giving rise to diagnostic challenges.
Poster 12: Benign and Borderline Heterologous Elements of Ovarian Sertoli-Leydig Cell Tumours with Associated High Serum AFP Levels: Two case reports
Two cases of Sertoli-Leydig cell tumours of ovary with benign to borderline heterologous elements, with one case showing elevated serum AFP levels.
Poster 13: A Case Report: Diagnostic Dilemma of Cystic Adult Granulosa Cell Tumour
Cystic adult granulosa cell tumours cause a diagnostic dilemma with the differential being a benign large follicular cyst. Diagnosis relies on key morphological features such as the presence of invaginations of the cyst lining into the wall and adult granulosa cell layers of >10 cells thickness. FOXL2 mutation can be absent.
Poster 14: Comparison of Pathological Findings Between Preoperative Biopsy Diagnosis and the Final Diagnosis at Hysterectomy in Patients with Endometrial Cancer and Endometrial Hyperplasia with Atypia
This poster summarizes the findings of the retrospective study done in High Wycombe hospital, Buckinghamshire NHS Trust to assess the concordance between preoperative endometrial sampling diagnoses and histological results from hysterectomy specimens in patients with endometrial hyperplasia with atypia (AEH) and endometrial cancer (EC), and factors influencing conservative management decisions. Our findings highlight strong concordance between preoperative diagnoses and hysterectomy results, particularly when compared to existing literature, supporting their reliability in guiding management decisions for endometrial pathologies.
Poster 15: Aggressive Metastatic Epithelial-rhabdoid Leiomyosarcoma of the Uterus. A Rare and Interesting Case Report
Metastatic and aggressive leiomyosarcoma of the uterus with epithelial-rhabdoid features in a 38 years old woman.
Poster 16: A Case of Pelvic Paraganglioma and Review of Sympathetic Paragangliomas of the Female Genital Tract
Paraganglioma of the pelvic soft tissue and female genital tract is an extremely rare diagnosis. These tumours have a worse prognosis than those arising in the adrenal gland and outcome is highly dependent on tumour stage.
Poster 17: Female Adnexal Tumor of Probable Wolffian Origin (FATWO) – A Case Report
FATWO – Be aware of this entity and its pathologic spectrum. The differential diagnosis can be challenging as they have a morphologic overlap with many of the common entities in ovary.
Poster 18: Departmental Review of Peritoneal Washings in Serous Borderline Tumours of the Ovary
We review our local practice of reporting peritoneal washings as part of the staging of serous borderline tumours of the ovary. Our review identifies no overdiagnosis of peritoneal washings as invasive adenocarcinoma. All samples containing atypical cells are associated with psammomatous calcification.
Poster 19: Clinicopathological Study of Endocervical Adenocarcinoma in a Tertiary Care Centre in South India with Incorporation of the new WHO 2020 Classification and its Association with Human Papillomavirus (HPV) Status Using p16 Immunohistochemistry
This is a retrospective study done over a period of 7 years where all primary endocervical adenocarcinoma cases where classified according to the new WHO 2020 classification/IECC system. There were 84 cases included in the study, 70(83.3%) were classified as HPV associated adenocarcinoma & 14 (16.6%) as HPV independent adenocarcinoma. Among HPVA cases, usual type was the commonest and in NHPVA cases, gastric type was the commonest. High concordance was noted between the p16 IHC & histomorphologic diagnosis. While comparing the two groups, early TNM/FIGO stage was noted more in the HPVA group. The NHPVA adenocarcinoma cases showed certain statistically significant differences in the clinico-radiologic and histomorphological features which had worse prognostic effect when compared to HPVA adenocarcinoma cases.
Poster 20: Leiomyosarcoma-like Undifferentiated Endometrial Cancer with Rhabdoid Features: A Rare Case Report with Loss of SMARCB1/INI1
SMARCB1/INI1 is a subunit protein known to be a tumour suppressor. In gynaecological cancers, the loss of SMARCB1/INI1 gene expression often occurs along with rhabdoid morphology and an unfavourable outcome. This case report highlights the importance of the expression of SMARCB1/INI1 to define a new histological subtype of endometrial carcinoma, which is still not included in the current WHO classification, encouraging adoption of new therapies for these tumours with rapid disease progression.
Poster 21:A Rare Case of Bilateral Mucinous Adenocarcinoma with Conspicuous Goblet Cell Morphology – A Conundrum of Etiological Uncertainty
A Conundrum of etiological uncertainty”- Problems due to goblet cell morphology- A young female presenting with bilateral ovarian neoplasm without any known primary revealed neoplasm in bilateral ovaries with a typical nest of goblet cells. Possible differentials starting from metastasis of goblet cell adenocarcinoma from appendix/gastrointestinal tract and goblet cell carcinoid from ovaries were considered, However the aggressiveness of disease, bilateral presentation and absence of neuroendocrine markers make this a challenging case to label with a name.
Poster 22: An Unusual Case: Investigation of Atypical Stromal Cells in an Endometrial Polyp Resulting in Revelation of an Endometrial Carcinoma
This is an interesting case of atypical stromal cells in an endometrial polyp that caused diagnostic dilemma in the biopsies and resulted in hysterectomy that revealed an incidental and more sinister abnormality.
Poster 23: Uterine Inflammatory Myofibroblastic Tumour with TIMP3-ALK Fusion: A Case Report
Case report of a 37yo woman presenting with rapidly enlarging fibroid and atypical radiology found to be a uterine inflammatory fibroblastic tumour with TIMP3-ALK fusion.
Poster 24: Chronic Ulcerative and Chronic Hypertrophic Vulval Herpes Virus Infection Mimicking Neoplasia: A Report of 4 Cases.
Chronic ulcerative and chronic hypertrophic vulval herpes virus infection mimicking neoplasia: A report of 4 cases.
Poster 25: Case study: Pregnancy Luteoma, a Mimicker of Ovarian Malignancy
A case of incidentally discovered bilateral pregnancy luteomas, a condition that mimics ovarian malignancy. We aim to raise awareness of this important benign diagnosis associated with a high risk of overtreatment.
Poster 26: An Unusual Myxoid Polyp of Endometrium in a Young Female – A Case Report
We report a case of Inflammatory Myofibroblastic Tumour of Uterus with characteristic morphology and IHC pattern which presented as a myxoid spindle cell polyp of endometrium in a young female.
Poster 27: A Persistent Pelvic Mass: Rare Case of Aggressive Angiomyxoma
Aggressive angiomyxoma (AAM) is a benign but locally infiltrative myxoid neoplasm occurring in deep soft tissue of the pelviperineal region.
Poster 28: Use of p16, p53 Immunohistochemistry and High-risk Human Papilloma Virus In Situ Hybridisation (HRHPV ISH) in Vulvar Intraepithelial Neoplasia and Invasive Carcinoma
An evaluation of the use of p16, p53 & HRHPV ISH in the prognostically important classification of VIN and vulval SCC into HPV-associated and HPV-independent categories.
Poster 29: Epithelioid Trophoblastic Tumor Masquerading as Ectopic Pregnancy in Uterine Caesarian Scar: A Case Report
37 year old presented as caesarian scar ectopic pregnancy. Persistent elevation of beta hCG despite excision and medical management. Subsequent hysterectomy performed revealed Epithelioid trophoblastic tumor.
Poster 30: B-catenin Aberrant Endometrioid like Epithelial Proliferation of the Fallopian Tube/E-TIN in a Patient with Endometrial Endometrioid Carcinoma: A Case Report.
Atypical endometrioid type proliferation of the fallopian tube (E-TIN) in a patient with endometrial endometrioid carcinoma: A case report.
Poster 31: Unmasking Pelvic Actinomyces: A Deceptive Mimicry of Malignancy – A Case Report
Actinomyces Israeli, as a vaginal commensal organism, has the rare potential to cause pelvic actinomycosis, particularly in prolonged intrauterine contraceptive device (IUCD) usage. This report explores a case of a 60-year-old woman, where pelvic actinomycosis was disguised as malignancy.
Poster 32: Uterine 13q/RB1 Family Tumour: A Case Report and Review of the Literature
Cellular angiofibroma/mammary myofibroblastomas are mesenchymal tumours that share a loss of the RB1 gene on chromosome 13q14. Although they almost exclusively found within the vulvo-vaginal region, we report the first case located within the uterine fundus.
Poster 33: COL1A1-PDGFB Fusion Uterine Sarcoma with High Grade Transformation to Pleomorphic Sarcoma: A Case Report and Review of the Literature
COL1A1-PDGFB gene fusion uterine sarcomas are rare, aggressive mesenchymal tumours. We report the eleventh case to date, and the first to show high grade transformation to pleomorphic sarcoma.
Poster 34: Uterine Adenosarcoma Arising in Adenomyosis: A Rare Presentation
Uterine adenosarcoma, a biphasic tumour of low malignant potential typically originates in the endometrium. We present an unusual case of adenosarcoma arising within adenomyosis with only 8 similar cases previously reported. A diagnostic and staging challenge due to limited data.
Poster 35: An Audit of Sentinel Lymph Node Ultra-Staging in Endometrial Cancer: Are Metastases Being Missed?
An audit of our endometrial cancer (EC) sentinel lymph node ultra staging protocol compared with the BAGP recommendations. Our metastases rate showed an additional 5% (N=3) were detected using more extensive protocols than the EC protocol.
Poster 36: Ovarian Endometrioid Carcinoma Recurring as a Mesonephric-like Carcinoma
We present an endometrioid/seromucinous carcinoma of the ovary diagnosed in 2016, recurring 7 years later as mesonephric-like carcinoma. Retrospectively focal ER negativity with mesonephric-like morphology was noted in the ovarian primary.
Poster 37: A Case Study of Ovarian Endometrioid Carcinoma with an Act of Mimicry
A case study of ovarian endometrioid carcinoma with an act of mimicry A 55 year old female with ovarian endometrioid carcinoma. She has a raised CA-125 and CT scan showed complex multilocular cystic and solid mass within pelvis, likely tubo-ovarian in origin.
Poster 38: Mucinous Adenocarcinoma Arising in a Sertoli-Leydig Cell Tumour with Heterologous Mucinous Elements in a Patient with Germline DICER1 Mutation
A rare case of a mucinous adenocarcinoma arising in an ovarian Sertoli-Leydig cell tumour and associated with elevated AFP in a patient with a germline DICER1 mutation.
Poster 39: HPV-Associated Multiphenotypic Carcinoma: First Description of a Vulval Case
HPV-associated multiphenotypic sinonasal carcinoma is a rare & recently described epithelial neoplasm, mainly reported in the nasal cavity & paranasal sinuses. We report the first vulval case in a patient presenting with a large craggy mass in the region of the Bartholin gland.
Poster 40: Mesonephric Adenocarcinoma of Female Genital Tract – “A Wolf in Sheep’s Clothing”
Mesonephric adenocarcinomas are rare aggressive neoplasms said to originate from mesonephric duct remnants and are included in the recent WHO 2022 Female Genital Tract.
Poster 41: Adenolipoleiomyoma of the Uterine Cervix: A Case Report and Review of the Literature
Adenolipoleiomyoma is a rare lesion of the uterus composed of Müllerian-type glands, smooth muscle and adipose tissue, with only one previous case reported in the cervix. Herein we describe a case report of adenolipoleiomyoma of the cervix.
Poster 42: An Audit on Homologous Recombination Deficiency (HRD) Testing in High-Grade Tubo-Ovarian Cancer: Efficiency, Impact, and Treatment Decision
This audit focuses on homologous recombination deficiency (HRD) testing in patients with non-mucinous high-grade tubo-ovarian cancer, looking into the proportion of patients with positive HRD status, and investigating the possible factors leading to a failed/inconclusive test.
Poster 43: Bilateral Ovarian Metastasis as a First Presentation of Ileocecal Neuroendocrine Tumor : A Case Report.
Neuroendocrine tumors (NETs) metastases to the ovaries are traditionally considered rare possibly due to the less case reports. Herein, we report a rare case of a 49‑year‑old woman who underwent total abdominal hysterectomy with bilateral salphingo-oophorectomy for heavy menstrual bleeding. On histological examination, incidental bilateral ovarian neuroendocrine tumor was reported, staining positively for chromogranin and CDX-2. Later, octreotide SPECT computed tomography (CT) showed tracer distribution of a 4cm caecal tumor overexpressing somatostatin receptor suggested of neuroendocrine tumor. The final diagnosis of grade 2 neuroendocrine tumour with peritoneal metastasis was made on a laparoscopic right hemicolectomy.
Poster 44: Case Report: p16 Negative HPV-associated Endocervical Adenocarcinoma
p16 immunohistochemistry is used as a surrogate marker for HPV infection in cervical neoplasia. We present a rare case of cervical cytology screen-detected endocervical adenocarcinoma which was negative for p16 immunohistochemistry.
Poster 45: Primary Angiosarcoma of Breast Metastasising to the Ovaries: A Case Report
A rare case of a primary breast angiosarcoma which subsequently metastasised to the ovaries with a review of immunohistochemical markers.
Poster 46: Uterine Dedifferentiated Leiomyosarcoma with Heterologous Differentiation and Associated Leiomyoma with Bizarre Nuclei: Report of a Rare Case
Uterine dedifferentiated leiomyosarcoma is a recently described, aggressive entity. Here we present a rare case of uterine dedifferentiated leiomyosarcoma with heterologous rhabdomyosarcomatous and chondrosarcomatous differentiation and associated leiomyoma with bizarre nuclei.
Poster 47: POLE NGS Testing in Endometrial Carcinoma: An Audit of Compliance with the BAGP Guidance in a Tertiary Cancer Centre
The BAGP advises sending all endometrial carcinoma biopsies with MMR and/or p53 abnormalities for POLE NGS testing. This audit assesses a tertiary cancer centre’s compliance with the BAGP guidance with regards to POLE NGS testing in endometrial carcinomas.
Poster 48: Establishing the Origin of Vaginal Cuff Adenocarcinoma with a Diffuse CDX2 Expression in the Absence of Morules Presents a Diagnostic Challenge in a Patient with Prior History of Endometrioid Carcinoma
This poster presents an unusual tumor displaying tubular morphology found in the vaginal cuff of a woman with a history of FIGO grade 1 endometrioid carcinoma. Clinical and radiographic findings were unsupportive of a gastrointestinal primary which, in addition to tumor morphology and immunohistochemical phenotype, raised the possibility of a recurrence of endometrial carcinoma with aberrant intestinal differentiation. Our presentation explores the morphology, immunohistochemical phenotype, and genetics of the hysterectomy and vaginal biopsy specimens to further characterize this rare entity.
Poster 49: An Audit of POLE Testing in the United Kingdom
Adopting universal POLE testing of all endometrial carcinomas at the time of diagnosis will reduce the turnaround times.
Poster 50: Audit of Homologous Recombination Deficiency (HRD) Testing in the West of Scotland in Ovarian Cancer – Is Biopsy Material Sufficient?
In this cohort, our HRD detection rate is 39%, BRCA mutation rate 20% and HRD failure rate 11% which is similar to that reported in previous studies3. This is contributed to mostly by poor cellularity biopsy samples. Post neoadjuvant specimens and cell blocks represented a very small proportion of the samples tested. Tumour volume is an important future consideration of genomics testing pathways particularly with the introduction of more complex testing methodologies such as whole genome sequencing.