Cervical adenocarcinoma with stromal micropapillary pattern

Abstract

Adenocarcinoma with a stromal micropapillary pattern (SMP) has been described in various organs, but not in the uterus. We encountered a case of uterine cervical carcinoma with SMP. A54-year-old Japanese woman was referred to the hospital with abnormal vaginal bleeding. The cervical cytodiagnosis was adenocarcinoma with features resembling serous adenocarcinoma. Cervical cytology showed many small clusters of tumor cells, present in up to two or three layers, composed of atypical cells with markedly increased nucleus: cytoplasm ratios. A radical hysterectomy with bilateral adnexectomy and retroperitoneal lymph node dissection was performed. Microscopically, the tumor was composed predominantly of adenocarcinoma with SMP. The outer surface of the SMP cell clusters showed membranous expression of mucin-1 (MUC-1). Many lymph node metastases were detected. The tumor was diagnosed as a cervical adenocarcinoma with SMP and coexistent squamous cell carcinoma in situ. The pathology was classified as T1b1N1M1, stage IVB. The patient underwent postoperative adjuvant chemotherapy and is without local recurrence or distant metastasis 48 months after the operation. To the best of our knowledge, this is the first reported case of cervical adenocarcinoma with SMP.

Cervical carcinomas with a micropapillary component: a clinicopathological study of eight cases

“…In the current study, three of the six patients with >12 months of follow‐up died of metastatic disease, and another was alive with distant metastasis. Three of the four previously reported patients with cervical MPC presented with stage IV disease; two of these patients died 1 and 6 months after diagnosis, whereas the third was disease‐free at 48 months . The fourth patient presented with a clinical stage IIB tumour but with pelvic and para‐aortic lymph node metastases; she was alive with disease 33 months after diagnosis .…”

“…Cervical carcinomas showing a micropapillary pattern appear to be very uncommon, and we are aware of only four detailed case reports describing such tumours . Two of these focused on the cytological aspects of the tumours, and another concentrated on the patient's clinical presentation with cardiac tamponade .…”

Cervical Adenocarcinomas: A Heterogeneous Group of Tumors With Variable Etiologies and Clinical Outcomes

“…72 Even micropapillary growth pattern of cervical adenocarcinoma that can mimic peritoneal serous carcinoma has been described, usually associated with a compo-nent of UEA and harboring HPV (Figure 8, A through C). [73][74][75][76][77] The evidence suggests that ''serous carcinoma'' of the cervix most likely represents a high-grade variant of HPVassociated UEA with ''serous-like'' features and that a certain proportion of so-called cervical serous carcinomas are likely drop metastases from the adnexa (assuming there is no endometrial lesion). If one is considering the diagnosis of primary endocervical serous carcinoma, metastases from the uterine corpus and adnexa, including occult tubal primary lesions, must be rigorously excluded.…”

Updated Review on Pathology of Endocervical Adenocarcinoma with Emphasis on Clinically Relevant Findings

“…Microscopically it is characterized by small, cohesive papillary groups of neoplastic cells surrounded by stromal clefting. It is often associated with lymphovascular space invasion and lymph node metastasis (8,9). The prognosis of this subtype is worse than pure usual type of endocervical adenocarcinoma.…”