Adenocarcinoma of the Uterine Cervix with Massive Signet-Ring Cell Differentiation

Abstract

Primary signet-ring cell adenocarcinoma of the cervix is very rare and less common than metastatic signet-ring cell adenocarcinoma. To the best of the authors' knowledge only one genuine case has been reported to date. Tvvo cases of primary signetring cell adenocarcinoma of the uterine cervix in patients aged 68 and 74 years are presented. The tumors were in stage IB. The light microscopic findings were confirmed by histochemical and immunohistochemical study. DNA nuclear analysis by flow cytometry of the neoplasms revealed an aneuploid (tetraploid) pattern. The patients had no evidence of recurrent or metastatic disease 35 and 25 months after a radical hysterectomy with bilateral salpingo-oophorectomy and lymph node dissection respectively. Primary signet-ring cell adenocarcinoma of the cervix should be differentiated from metastatic adenocarcinoma, endocervical involvement by signetring cell carcinoma of the endometrium, benign mucin-filled signet-ring cell aggregates that may accumulate in mucosal folds, microglandular hyperplasia, mucicarminophilic histiocytosis, and other malignant neoplasms that may have signet ring-like cells and deserve consideration such as squamous cell carcinoma, malignant lymphoma, myeloma, and malignant melanoma. Although very rare, signetring cell adenocarcinoma of the cervix can exist as a primary tumor. Distinction between a primary neoplasm and a metastasis to the cervix is decisive for treatment and prognosis. Int J Surg Pathol 5(3/4): [95][96][97][98][99][100] 1997 Adenocarcinomas of the uterine cervix at present account for from 10% to 20% of invasive carcinomas of the cervix in developed countries [1,2]. This apparent increased frequency of adenocarcinomas results from a decrease in the incidence of the invasive squamous cell carcinoma and a real absolute increment of the glandular tumors [3]. Although less common than squamous cell carcinomas, adenocarcinomas are far more difficult to diagnose in the

Primary signet ring cell carcinoma of the uterine cervix: A case report

“…To the best of our knowledge, only 10 cases of primary signet ring cell carcinoma in the uterine cervix previously have been reported [4][5][6][8][9][10][11][12]. Three cases have documented survival time longer than 2 years and one case of them showed extended survival in a low stage tumor (8 years, FIGO stage IB) [8,12].…”

“…Three cases have documented survival time longer than 2 years and one case of them showed extended survival in a low stage tumor (8 years, FIGO stage IB) [8,12]. In a Korean case, survival period after operation and concurrent chemoradiation therapy was only 6 months like in this case [9].…”

A New Case of Primary Signet Ring Cell Carcinoma of the Uterine Cervix: A Case Report and Review of the Literature

“…Mucinous adenocarcinoma of signet-ring cell type is very rare [4,5]. Usually, signet-ring cell differentiation found in cervical carcinoma strongly suggests a metastatic carcinoma usually from a gastro-intestinal, appendicular, mammary or ovarian origin [1,6]. To the best of our knowledge, only 20 cases (included our case) of primary cervical carcinoma containing signet-ring cell morphology have been reported in the literature (Table 1).…”

“…To the best of our knowledge, only 20 cases (included our case) of primary cervical carcinoma containing signet-ring cell morphology have been reported in the literature (Table 1). In most cases of previous reports, the signet-ring cell component is included in a part of histological types [6]. All cases were admitted as primary only after a careful combined clinical, endoscopic and radiological investigation to rule out the presence of an occult primary site.…”

Metástasis de carcinoma de células en anillo de sello al cuello uterino

“…El pronóstico de las pacientes con metástasis de carcinoma de células en anillo de sello al cuello uterino es malo, y no hay razones para esperar un mejor comportamiento para tumores primarios del cérvix con la misma histología, a pesar que hay algunos casos descritos con sobrevidas mejores en estos últimos casos (5,36,37). Recientemente, se ha sugerido que el compromiso metastásico al útero y al peritoneo desde un carcinoma mamario no debería ser considerado un evento preterminal y se enfatiza en el rol que pudiera tener la cirugía de citoreducción y quimioterapia en pacientes seleccionadas (38).…”