Adenocarcinoma of the uterine cervix with choriocarcinomatous metastasis

BACKGROUND: Nongestational choriocarcinoma, in very rare instances, has been described as a component of other malignancies with a tendency for a very poor prognosis. CASE: A 55 year old woman was diagnosed with adenocarcinoma of the cervix, and incompletely treated with only external beam radiation. Adjuvant radical hysterectomy demonstrated no residual tumor, but the patient developed a tumor metastasis mimicking a pulmonary artery thrombus which by histology and immunohistochemistry was pure choriocarcinoma. While chemotherapy was successful in achieving a complete remission, the patient succumbed to complications of her pulmonary metastasis. CONCLUSION: Choriocarcinomatous dedifferentiation of cervical adenocarcinoma is extremely rare, with only one other case reported in the literature. While the prognosis for patients with such a tumor is generally poor, aggressive combination chemotherapy may be of benefit in some.     

Adenocarcinoma of the uterine cervix with beta-hCG production: a case report and review of the literature

The production of unexpected cell products, including the placental protein human chorionic gonadotrophin (hCG), has been reported in a variety of tumors at different anatomical sites. Some of the reported tumors have also expressed morphological features suggesting choriocarcinoma. Such is the case in this tumor of the uterine cervix which has a major component of anaplastic tumour with beta-hCG production confirmed both by positive staining using immunoperoxidase techniques and by pre- and postoperative serum assays for beta-hCG. The differing immunohistochemical features seen in the two components of the tumor are reported. The relationship of the anaplastic component to the adjacent mucinous adenocarcinoma in the present case, and to similar cases at other sites from the literature, is discussed.     

Adenocarcinoma of the uterine cervix.

From January 1, 1947, through December 31, 1971, 219 patients with primary adenocarcinoma of the intact uterine cervix were treated at the M.D. Anderson Hospital and Tumor Institute. Two modes of therapy were primarily used, namely, irradiationtherapy alone and irradiation therapy plus operation. The 5 year survival resultsare 83.7 per cent for patients with Stage i disease, 48.0 per cent for patients with Stage ii disease, 29.2 per cent for patients with Stage iii disease, and 0.0 per cent for patients with Stage iv disease. The group with irradiation plus operation had a better over-all survival rate. In addition, the incidence of central and pelvic recurrent disease was remarkably lower (fourfold difference). The urologic and bowel complications are discussed. This review lends support for our practice of preoperative irradiation followed by simple (constructive) hysterectomy for selected patients eith adenocarcinoma of the uterine cervix.     

Adenocarcinoma of the uterine cervix.

One hundred and two cases of adenocarcinoma of the cervix treated from 1963 to 1968 were analyzed. The overall treatment results were poorer than for patients with squamous cell carcinoma treated in the same period. Comparing the results in this series with those of an earlier report from the same institution, it was found that the prognosis had improved only in early cases of adenocarcinoma and that this improvement was linked to increased use of surgery. Data presented suggest a possible biological difference in tumors developing before and after the menopause.     

Primary hepatoid adenocarcinoma of the uterine cervix

Hepatoid adenocarcinoma is characterized histologically by neoplastic epithelial cells that resemble hepatocellular carcinoma (HCC) and produce alpha-fetoprotein (AFP). We describe a case of hepatoid adenocarcinoma of the uterus that, unlike any other previously reported case, was strictly confined to the cervix. A cervical biopsy demonstrated poorly differentiated adenocarcinoma, and hysterectomy and bilateral salpingo-oophorectomy were subsequently performed. Histologically, the lesion consisted of solid sheets of hepatoid cells accompanied with areas of endometroid adenocarcinoma. The tumor cells showed strong and diffuse cytoplasmic immunoreactivity with AFP in both medullary and adenocarcinoma components. Metastases to bilateral pelvic lymph nodes were detected 12 months after surgery. Since undergoing total pelvic irradiation, the patient has been alive and in full remission for 22 months. To our knowledge, this is the first report of primary hepatoid adenocarcinoma of the uterine cervix.     

Sebaceous carcinoma of the uterine cervix: a case report.

Sebaceous carcinoma is an uncommon neoplasm that usually arises in the head and neck region. A few cases of sebaceous carcinoma of the female genital tract have been reported, most of which arose in the vulva. We report the first case of sebaceous carcinoma of the uterine cervix. A 25-year-old, nulligravida woman presented with genital bleeding; there was a history of systemic lupus erythematosus but not Fordyce's disease. A 3.8-cm exophytic lesion on the cervix was biopsied and staged FIGO stage IB1. A radical hysterectomy was performed. On pathological examination, the tumor replaced the entire cervix and extended into the left parametrium and posterior vaginal fornix. On microscopic examination, the tumor was a sebaceous carcinoma, similar to those described in other sites. Postoperative radiotherapy was administered, but the patient died of tumor 8 months postoperatively.     

Adenocarcinoma of the lung metastatic to the uterine cervix: a case report and review of the literature

Hollier LM, Boswank SE, Stringer CA. Adenocarcinoma of the lung metastatic to the uterine cervix: A case report and review of the literature. Int J Gynecol Cancer 1997; 7: 490–494.
Adenocarcinoma metastatic to the uterine cervix is rare. When it occurs, extragenital primary disease is often in the gastrointestinal tract or breast. We report a case of adenocarcinoma of the lung which metastasized to the uterine cervix. Six months after treatment for lung cancer, the patient was referred for evaluation of vaginal bleeding. She had a visible cervical lesion and biopsy confirmed adenocarcinoma with cells identical to the lung primary. She had no evidence of systemic disease. The patient was palliated with total abdominal hysterectomy and bilateral salpingo-oophorectomy. Were view the literature and stress the importance of appropriate diagnosis of cervical adenocarcinoma.     

Melanosis of the uterine cervix: a case report

BACKGROUND: Melanosis of the uterine cervix is a rare, benign, melanocytic lesion of the cervix. A review of the English-language literature revealed 11 other reported cases. CASE: A 52-year-old African American woman who presented for evaluation and treatment of menorrhagia was found to have an irregular, pigmented cervical lesion. The ectocervical biopsy showed melanosis characterized by hyperkeratosis, acanthosis and prominent elongation of rete with abundant basilar pigmentation. Immunohistochemical staining showed scattered, basally situated, S-100 protein-positive melanocytes. CONCLUSION: The existence of this entity is further evidence of a spectrum of melanocytic lesions, including blue nevi and primary melanomas, known to occur within the cervix proper.     

Endometrioid carcinoma of the endometrium with choriocarcinomatous differentiation: a case report and review of the literature

OBJECTIVE: An endometrioid adenocarcinoma (EAC) with true trophoblastic differentiation is a rare event with a highly aggressive clinical course. CASE: We report an endometrioid adenocarcinoma of the endometrium in which there was a morphologically conventional-appearing EAC component admixed with multinucleated giant cells and large pleomorphic tumor cells that resembled a choriocarcinoma without an elevated serum level of human chorionic gonadotropin (hCG) in a 42-year-old unmarried woman with a history of abnormal uterine bleeding. A total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection were performed. Histopathologic study of the specimen showed endometrioid adenocarcinoma extended to the deep myometrium with a focus of hemorrhagic and necrotic tumor composed of multinucleated giant cells, large pleomorphic tumor cells, suggesting choriocarcinomatous differentiation (CD). Immunohistochemical studies demonstrated intense reactivity of tumor cells for human chorionic gonadotropin (hCG) confirming the diagnosis. A complete clinical workup ruled out metastatic spread to the brain, lungs, skeleton, or abdomen. The patient was alive with no evidence of disease 6 months later. CONCLUSION: Although endometrioid adenocarcinoma with choriocarcinomatous differentiation is known to behave in a more aggressive course, this disease may have a good prognosis with a clinically indolent course when it is small, and without elevated serum hCG levels.     

Primary malignant melanoma of the uterine cervix: a case report.

We report on a case of a malignant melanoma of the uterine cervix. Histological and immunohistological examinations of a postsurgical specimen revealed malignant melanoma. The junctional activities did not occur due to extensive superficial ulceration. Radical surgery was performed. The patient is doing well and free of symptoms at this time, 2 1/2 year later.     

Adenocarcinoma of the uterine cervix

Adenocarcinoma of the cervix represented 12.7% of all cervical carcinomas seen at the University of Washington. The mean age of 66 patients with adenocarinoma of the cervix was not significantly different from the mean age of those with squamous cell carcinoma and was 43.6 (range 15–83). Seventy-six percent of the patients were assigned to Stage I disease. Stage II disease was diagnosed in 15% and Stages III–IV represented 9%. The pathologic diagnosis included adenocarcinoma in 50 patients, adenosquamous carcinoma in 9, clear cell carcinoma in 5, and adenoid cystic carcinoma in 2. The survival rate was directly related to the stage of disease and to the presence or absence of lymph node metastasis. The recurrence rate was significantly higher in adenocarcinoma of the cervix with node metastasis when compared with a similar group of patients with squamous cell carcinoma.     

Liposarcoma of the uterine cervix: case report

A case of primary liposarcoma of the cervix is described in a 49-year-old woman with a fungating cervical mass which was diagnosed as liposarcoma on the basis of cytologic features and the intracellular lipids. Most of the adipocytes and vacuolated lipoblasts were positive for S- 100 protein. The mass was well circumscribed and limited to the superficial cervical stroma. A total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy was performed. There was no clinical evidence of metastasis two years after the operation.