J Korean Med Sci.  2009 Aug;24(4):767-771. 10.3346/jkms.2009.24.4.767.

Endometrioid Adenocarcinoma Arising from Endometriosis of the Uterine Cervix: A Case Report

Affiliations
  • 1Department of Obstetrics and Gynecology, Gangneung Asan Hospital, University of Ulsan, Gangneung, Korea. silabus@hanmail.net
  • 2Department of Pathology, Gangneung Asan Hospital, University of Ulsan, Gangneung, Korea.

Abstract

Endometrioid adenocarcinoma arising from endometriosis of the uterine cervix is rare in premenopausal woman. We describe here a patient with this condition and review the clinical and pathological features of these tumors. A 48-yr-old woman complaining of severe dysmenorrhea was referred for investigation of a pelvic mass. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. Histological examination revealed an endometrioid adenocarcinoma directly adjacent to the endometriosis at the uterine cervix, with a transition observed between endometriosis and endometrioid adenocarcinoma. The patient was diagnosed as having endometrioid adenocarcinoma arising from endometriosis of the uterine cervix and underwent postoperative chemotherapy. Gynecologists and pathologists should be aware of the difficulties associated with a delay in diagnosis of endometrioid adenocarcinoma arising from endometriosis when the tumor presents as a benign looking endometrioma.

Keyword

Carcinoma, Endometrioid; Endometriosis; Cervix Uteri

MeSH Terms

Carcinoma, Endometrioid/*diagnosis/etiology/pathology
Cervix Uteri/*pathology
Diagnosis, Differential
Endometrial Neoplasms/*diagnosis/etiology/pathology
Endometriosis/complications/*diagnosis/pathology
Female
Humans
Hysterectomy
Magnetic Resonance Imaging
Middle Aged
Ovariectomy

Figure

  • Fig. 1 MRI findings of the patient. On T1, T2W sagittal images (A, B), showing multiple round masses of variable size on the uterine cervix (arrows). Adenomyosis was observed in the body of the uterus, but no enlarged lymph nodes or ascites was observed.

  • Fig. 2 Cut surface of the cervical wall showing well defined hemorrhagic solid lesions (arrow).

  • Fig. 3 Histopathological findings. (A) Dilated endocervical glands in the cervix. There was no evidence of adenocarcinoma or connection with the endometriotic cyst (H&E, ×40). (B) Direct continuity was observed from the endometriosis (left upper) to the endometrioid adenocarcinoma (right side) in the cervix (H&E, ×100). (C) High-power view of endometrioid adenocarcinoma in the cervix (H&E, ×400).


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