Obstet Gynecol Sci.  2018 Jan;61(1):165-169. 10.5468/ogs.2018.61.1.165.

Gastric type mucinous endocervical adenocarcinoma of the uterine cervix: very rare and interesting case

• Park CM
• Koh HM
• Park S
• Kang HS
• Shim SS
• Kim SY

• KMID: 2420167
• DOI: http://doi.org/10.5468/ogs.2018.61.1.165

Abstract

Gastric type mucinous endocervical adenocarcinomas of the uterine cervix (GAC) are a newly classified mucinous subtype with morphologically in 2014, WHO. They have a much more aggressiveness and show unusual metastatic patterns compared to usual type endocervical adenocarcinoma. They tend to present at higher stage and even in stage I, they have worse survival. Therefore, differential diagnosis of GAC from the usual type of endocervical adenocarcinoma is very important because they are related to a significant risk of recurrence and decreased 5-year disease-specific survival. Besides, GACs are mostly not associated with human papillomavirus (HPV) infection and p16 immunohistochemistry is also typically negative in GAC that is HPV-unassociated tumor. We report a very rare and interesting case of stage IB1 GAC with negative HPV DNA and p16.

Keyword

Adenocarcinoma; Mucinous; Gastric type; Human papillomavirus

MeSH Terms

Adenocarcinoma*
Cervix Uteri*
Diagnosis, Differential
DNA
Female
Humans
Immunohistochemistry
Mucins*
Recurrence
DNA
Mucins

Figure

• 

  Fig. 1 Pelvis magnetic resonance imaging (MRI) revealed a 3.9 cm sized cervical mass without parametrial and vaginal extension.

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  Fig. 2 The positron emission tomography-computed tomography (PET-CT) scan showed a heterogenous, moderate fluorodeoxyglucose (FDG) uptake in uterus area which was suspected of malignancy, but there is no significant abnormal FDG uptake to suggest metastatic lymph node (LN) and distant metastasis.

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  Fig. 3 Histologic (A-D; Hematoxylin and Eosin stain) and immunohistochemical (E; p16 stain, F; CK7 stain) findings. (A) Microscopic examination shows atypical glands extended below the normal level expected for benign endocervical glands. The glands are irregular and dilated with gastric differentiation. (B) The tumor shows gastric type differentiation with abundant clear or pale, eosinophilic cytoplasm with atypical nucleus. (C) The tumor invades the myometrium. (D) Tumor cells metastasize to the regional lymph nodes. (E, F) Immunohistochemical stains are negative for p16 (E), positive for CK7 (F).

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