Is further workup and management required for an incidentally found small focus of neuroendocrine tumor of the endometrium?

It depends on the grade and differentiation. Primary endometrial tumors are very rare and tend to be high grade and poorly differentiated. A lower grade tumor, especially an implant on the peritoneal surface, is much more likely to be a metastasis, most likely from a GI primary. A sample obtained at a laparoscopy suggests there was an implant on the peritoneal surface and as such, suggests this being a metastasis. I would discuss with the surgeon who performed the laparoscopy what he actually found, if it was typical for endometriosis and how widespread the abnormalities were within the peritoneal cavity.

I would start by asking the pathologists to comment on the grade (using Ki67 proliferative index) and mitotic count. If grade 1 or 2, I wo...