Latest updates in the histopathological and molecular approach of endometrial carcinoma

Endometrial carcinomas are one of the most frequent carcinomas of the female genital tract. This article aims to highlight the particularities of both histopathological, immunohistochemical and molecular aspects, according to the new World Health Organization (WHO) Classification of endometrial tumors. These tumors can be divided into 4 groups, depending on the mutation that is present, which impacts the prognosis and consequently also the treatment of these patients. Tumors with the best prognosis are part of the low-risk category and are those harboring the POLE mutation, while on the opposite spectrum, TP53 mutated tumors are known to have an aggressive evolution. A thorough literature search has been performed in order to extract the up-to-date information that has been furtherly synthesized. The articles obtained have been reviewed, correlating the histological and molecular features with treatment and prognosis. Although no known reliable immunohistochemical stain can identify the presence of the POLE mutation, molecular analysis is necessary in order to further classify these tumors and to identify the cases that need to be put in the high-risk or high-intermediate risk categories. Considering the good prognosis of carcinomas with POLE mutations, the identification of these cases is recommended due to the possible descaling of treatment.