Clear Cell Endometrial Carcinoma: A Case Report and Review of Current Molecular Classification and Management

Abstract

Introduction: Clear cell carcinoma of the endometrium (CCCE) is a rare but highly aggressive histological subtype of endometrial cancer characterized by early extrauterine spread and poor clinical outcomes. Recent advances in molecular classification have improved risk stratification and may guide individualized treatment strategies.

Case Presentation: We report the case of a 45-year-old woman diagnosed with advanced clear cell carcinoma of the endometrium. Following comprehensive clinical and pathological evaluation, the patient received palliative systemic chemotherapy with paclitaxel and carboplatin because of advanced-stage disease. Histopathologically, CCCE is classified as a type II endometrial carcinoma and is commonly associated with abnormal p53 (p53abn) or no specific molecular profile (NSMP), whereas pathogenic POLE mutations and mismatch repair deficiency (MMRd) are relatively uncommon.

Discussion: Current evidence suggests that the molecular profile of CCCE has important prognostic and therapeutic implications. Tumors with p53 abnormalities generally exhibit aggressive biological behavior and poorer survival outcomes, emphasizing the importance of molecular classification in treatment planning.

Conclusion: Clear cell carcinoma of the endometrium is an uncommon but highly aggressive malignancy with an unfavorable prognosis. Early diagnosis, accurate histopathological and molecular characterization, and multidisciplinary management are essential to optimize patient outcomes.