Clinicopathological Characteristics of Microscopic Tubal Intraepithelial Metastases from Adenocarcinoma and Small Cell Neuroendocrine Carcinoma of the Uterine Cervix

Abstract

Background/Aim: Some metastatic tumors that involve the fallopian tube show intraepithelial spread, mimicking primary tubal neoplasm and representing a potential diagnostic pitfall. In this study, we aimed to investigate the clinicopathological characteristics of tubal intraepithelial metastasis (IEM) from cervical carcinoma. Patients and Methods: We analyzed the clinical features, histological features, and immunophenotypes of IEMs in five patients with cervical carcinoma. Results: This study included usual-type (1/5), mucinous-type (1/5), and gastrictype (2/5) endocervical adenocarcinomas and small cell neuroendocrine carcinoma (1/5) cases. None of the patients had ovarian metastasis, but metastatic tumor cells spread along the tubal mucosal surface and partially replaced the lining epithelium. Histological features of metastatic tumors closely resembled those of the primary tumors in all cases. Conclusion: Tubal IEM can mimic various tubal lesions including serous tubal intraepithelial carcinoma. Morphological consistency between the primary and metastatic tumors and immunostaining help guide the differential diagnosis of challenging intraepithelial lesions of the fallopian tube.Cervical carcinoma is one of the commonest causes of carcinoma-related mortality among women worldwide. The incidence and mortality rates of cervical carcinoma have decreased significantly in developed countries since the introduction of the cervicovaginal cytology screening program, which has facilitated the detection and treatment of precursor lesions (i.e. high-grade squamous intraepithelial lesion and adenocarcinoma in situ) (1). Despite the high efficacy of local treatment for the precursor lesions, treated women continue to represent a high-risk group, with high recurrence rates of 5-10% (2). Furthermore, despite increased surveillance, for several years after treatment, these women have a higher risk of invasive carcinoma than women in the general population (3). In 2018, approximately 570,000 women developed cervical carcinoma and 311,000 women died from it (4, 5).Squamous cell carcinoma is the commonest histological subtype arising in the uterine cervix, which accounts for 70% of all cervical carcinoma cases (6). Endocervical adenocarcinoma and high-grade neuroendocrine carcinoma comprise approximately 25% and 2%, respectively (6, 7). A recent large-scale study revealed that the most frequent anatomic site of metastatic cervical carcinoma was the lungs (37.9%), followed by the bone (16.7%), liver (12.5%), and brain (1.6%) (8). Adnexal metastasis of cervical carcinoma is relatively uncommon. The incidence of ovarian metastases ranges 2.0-28.6% and 0-17.4% for endocervical adenocarcinomas and squamous cell carcinomas, respectively. The clinicopathological characteristics of cervical carcinoma that involves the ovaries have been well documented (9), whereas only a few studies have investigated metastatic cervical carcinoma to the fallopian tube (10).Most of the tubal metastases from gynecological malignancies are associated with ...

Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors

“…Briefly, 4-µm-thick, formalin-fixed, paraffin-embedded (FFPE) tissue slices were deparaffinized and rehydrated using a xylene and alcohol solution. IHC was performed using a BOND-MAX automated immunostainer (Leica Biosystems, Buffalo Grove, IL, USA) [1,8,9,[16][17][18][19][20][21]. After antigen retrieval, the slices were incubated with the primary antibodies (Table 1).…”

Mesonephric-like Carcinosarcoma of the Uterine Corpus: Clinicopathological, Molecular and Prognostic Characteristics in Comparison With Uterine Mesonephric-like Adenocarcinoma and Conventional Endometrial Carcinosarcoma

“…FFPE tissue blocks were sectioned at 4 μm on a standard rotary microtome, and sections were placed in a water bath on microscopic glass slides. Expression of p53 protein was assessed by immunohistochemistry using a BOND-MAX automated immunostainer (Leica Biosystems, Buffalo Grove, IL, USA) (6,8,9,12,17,(33)(34)(35)(36)(37). After antigen retrieval, the sections were incubated with anti-p53 antibody (dilution 1:200, clone DO-7, catalog number NCL-L-p53-DO7, Leica Biosystems).…”

Endometrioid Carcinomas of the Ovaries and Endometrium Involving Endocervical Polyps: Comprehensive Clinicopathological Analyses

“…We performed immunohistochemical staining based on previously described methods [ 17 , 18 , 19 , 20 , 21 , 22 ]. Immunohistochemical staining was performed using the Bond Polymer Intense Detection System (Leica Biosystems, Buffalo Grove, IL, USA).…”