Expression of EGFR family and p53 in a patient with Synchronous Primary Endometrial Adenocarcinoma and Clear Cell Renal Carcinoma: a Case Report

ABSTRACT

We present a case of a 69 year-old, non-obese, post-menopausal woman diagnosed with synchronous endometrial adenocarcinoma and renal cell carcinoma. Immunolocalization and expression of the EGFR, HER-2, HER-3, HER-4 and p53 proteins by immunohistochemistry (IHC) was performed to investigate synchronous expression of these proteins. The endometrial adenocarcinoma was a well-differentiated tumor, with discernable glandular structure with moderate mitotic index. IHC revealed weak HER-2, HER-3 and HER-4 staining of cell membranes in well-differentiated areas, and intense HER-2 and p53 staining in papillary areas. The renal cell carcinoma showed clear cell type, solid tumor, Fuhrman nuclear grade 2, presence of necrosis and hemorrhage. IHC revealed intense HER-2 and HER-4 staining of cell membranes, weak EGFR staining, and negative expression for HER3 and p53 protein. In summary, overexpression of HER-2 and HER-4 may correlate with histological grade of the tumor and patient prognosis.

RESUMO

Apresentamos um relato de caso de uma paciente com 69 anos, não-obesa, pós-menopausa, diagnosticada com adenocarcinoma endometrial simultâneo ao carcinoma de células renais. A imunolocalização e expressão das proteínas EGFR, HER-2, HER-3, HER-4 e p53 através de imunohistoquímica (IHC) foi realizada para investigar a simultaneidade na expressão dessas proteínas em ambos tumores. O adenocarcinoma endometrial era um tumor bem diferenciado, com estruturas grandulares discerníveis e com índice mitótico moderado. A IHC revelou fraca marcação das proteínas HER-2, HER-3 e HER-4 nas membranas celulares em áreas bem diferenciadas, e marcação intensa de HER-2 e p53 em áreas papilares. O carcinoma de células renais apresentou tipo células clara, tumor sólido, grau 2 de malignidade nuclear, presença de necrose e hemorragia. IHC revelou marcação intensa de HER-2 e HER-4 nas membranas celulares, fraca de EGFR e negativa para HER-3 e p53. Em resumo, a super expressão das proteínas HER-2 e HER-4 podem estar correlacionadas ao grau histológico dos tumores e ao prognóstico da paciente.

Keywords:

Endometrial carcinoma - Renal clear cell carcinoma - EGFR family - p53

Descritores:

Carcinoma Endometrial - Carcinoma renal de células claras - Família EGFR - p53

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