23 August 2024
: Case report 
Challenges in Diagnosing Metastatic Uterine PEComa: Insights from Two Case Studies
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare disease
Cédric Kabeya1ABDEF*, Mathilde Lancelle1E, Gregory Demolin2DE, Céline Wattier1E, Camille Marchisello2E, Antonino Buonomo1ABDEF, Sandhya Fonseca3ABDEDOI: 10.12659/AJCR.944365
Am J Case Rep 2024; 25:e944365
Table 1. Morphological and immunohistochemical characteristics of mesenchymal neoplasms of the female genital tract. Fitzpatrick et al [10].
| Feature | PEComa | Leiomyosarcoma | Endometrial stomal sarcoma | Case 1 | Case 2 |
|---|---|---|---|---|---|
| Epithelioid cells | Usual | Rarely | +/– | + | + |
| Spindle cells | Usual | Usual | Usual | – | + |
| Multinucleated giant cells | Usual | Usual | Absent | – | + |
| Capillary network | Usual | Absent | Usual, but no radiation | – | + |
| Clear cells | Usual | Occasional | +/– | – | – |
| Eosinophilic cells | Usual | Usual | +/– | + | + |
| Islands of endometrial tissue | Absent | Absent | Usual | Absent | Absent |
| Desmin immunopositivity | 63% | 86% | 50% | +++ | + |
| SMA immunopositivity | 80% | 100% | 63% | +++ | + |
| HMB-45 immunopositivity | 99% | 36% | 24% | + | +++ |
| CD 10 immunopositivity | 14% | 50% | 96% | + |