J Menopausal Med.  2015 Dec;21(3):171-174. 10.6118/jmm.2015.21.3.171.

Uterine Serous Adenocarcinoma in an Elderly Postmenopausal Woman: Clinically Misdiagnosed as Uterine Cervix Cancer

• Hong JA
• Kim TH
• Lee HH
• Chung SH
• Heo GE
• Jeon DS
• Kwak JJ
• Choi SD
• Han E

• KMID: 2200972
• DOI: http://doi.org/10.6118/jmm.2015.21.3.171

Abstract

Uterine serous adenocarcinoma (USC) is rare and invasive cancer. This cancer is more often reported in the ovary, the fallopian tube, and the endometrium than uterine cervix. No matter where the tumor is located, the tumor exhibits similar histological characteristics. So when uterine cancer is proven to be serous adenocarcinoma, it is necessary to see if the tumor originated from ovary or endometrium and invaded the cervix. We report a case of a 73-year-old postmenopausal woman with USC arising near the internal os of endocervical canal, clinically misdiagnosed as uterine cervix cancer.

Keyword

Cystadenocarcinoma serous; Tomography X-ray computed; Uterine cervical neoplasms; Uterus

MeSH Terms

Adenocarcinoma*
Aged*
Cervix Uteri*
Endometrium
Fallopian Tubes
Female
Humans
Ovary
Uterine Cervical Neoplasms
Uterine Neoplasms
Uterus

Figure

• 

  Fig. 1 Endometrial mass showed by ultrasonography, computed tomography and intraoperative finding. A Pelvic ultrasonography showed solid mass protruding from uterine cervical canal into uterine cavity (distance 29 mm). B The huge cystic mass on the right pelvic cavity was thought to be hydrosalpinx or right ovarian benign cystic tumor. There was adjacent thick-walled cystic mass with solid enhanced mass (A) within, which was thought to be underlying cervical cancer or endometrial cancer of lower uterine segment. Also, endometrial cavity was distended with suspected hemorrhage due to aforementioned cancerous lesion. No enlarged lymph node was noted. C Intrauterine mass (A) exposed after hysterotomy and suctioning the blood within the uterus.

• 

  Fig. 2 Pathologic findings by hematoxylin & eosin (H & E) stain and immunohistochemistry. A Microscopic findings show large, broad, irregular papillae lined by cuboidal to irregularly stratified tumor cells with a high nuclear-cytoplasmic ratio and macronucleoli. (A) Hysterectomized uterus after polypectomy is grossly unremarkable. (B) Sections show several irregular neoplastic papillae with irregularly stratified tumor cells (H & E ×40). (C) Tumor cells reveal severe nuclear atypia, frequent mitoses and apoptotic bodies (H & E ×200). (D) Solid proliferation of tumor cells with pleomorphic nucleus is also noted (H & E ×200). B The tumor cells reveal strong positivity in immunohistochemical stain of P53 and WT-1 and estrogen receptor. Immunohistochemical stain of CK5/6 was negative. Immunohistochemical stain of P53 (A) and WT-1 (B) show diffuse strong positivity in nucleus of tumor cells.

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