J Gynecol Oncol.  2009 Dec;20(4):251-253. 10.3802/jgo.2009.20.4.251.

A case of advanced gynecologic pelvic tumors showing the diagnostic utility of HPV analysis

• Lee HB
• Lee YS
• Lee KH
• Kim CJ
• Park JS

• KMID: 2288592
• DOI: http://doi.org/10.3802/jgo.2009.20.4.251

Abstract

Gynecologic malignancies may have similar histological characteristics. This may lead to difficulties in determining the origin of the cancer and to distinguish a synchronous neoplasm from a metastatic cancer in advanced cases. Recently, we treated a 59-year-old patient with adenocarcinoma of the uterine cervix, endometrium, fallopian tubes, and ovaries. It was difficult to determine whether the cancer was a single origin metastatic cancer or a synchronous neoplasm. The patient was finally diagnosed with metastatic cancer that originated from the uterine cervix by human papillomavirus (HPV) test. Here we report the case and briefly review of the medical literature.

Keyword

Cervical adenocarcinoma; Human papillomavirus; Metastatic cancer; Synchronous neoplasm

MeSH Terms

Adenocarcinoma
Cervix Uteri
Endometrium
Fallopian Tubes
Female
Humans
Middle Aged
Neoplasms, Multiple Primary
Ovary

Figure

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  Fig. 1 Colposcopic appearance of the cervical mass shows surface irregularity and atypical blood vessels prone to bleeding.

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  Fig. 2 Sagittal T2-weighted image (A) shows a lobulated mass in the uterine cervix with heterogeneous signal intensity. On the axial T2-weighted image (B), multiseptated cystic masses with multiple irregular septa and some solid portions were detected in both adnexa. A dilated endometrial cavity with poorly defined, cotton-ball like endometrial surface represents endometrial spreading of the tumors.

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  Fig. 3 (A) There is an ill-defined mass in the uterine cervix with direct invasion into the endometrium. (B) Multilocular cystic mass of ovary and tensely dilated fallopian tubes are noted.

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  Fig. 4 The tumor is composed of malignant glands showing papillary, micropapillary and cribriform growth (H&E, ×400).

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