Gastric-Type Adenocarcinoma of the Uterine Cervix

Park, Kye Jin; Kim, Mi‐Hyun; Kim, Jeong Kon; Cho, Kyoung‐Sik

doi:10.1097/igc.0000000000001275

Cited by 21 publications

(15 citation statements)

References 22 publications

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“…Examples of characteristic magnetic resonance images are presented in Figure 1 [25]. Therefore, the radiologic features confirm the microscopic data, and included characteristics generally considered as contra-indications to fertility surgery in the common HPV-related type cervical cancer: large size, stromal invasion, involvement of the entire endocervix up to the internal os.…”

Section: Radiologic Featuresmentioning

confidence: 52%

Fertility Sparing Treatment in Gastric-Type Endocervical Carcinoma

Rychlik¹,

Querleu

Bidziński³

2021

Cancers

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Fertility sparing management of cancer is one of the main components of quality-of-life issues. Early-stage cervical cancer, frequently diagnosed in women of reproductive age, can potentially be treated conservatively. However, some rare histological types of cervical cancer present with aggressive clinical behavior. Particularly, in the newly introduced concept of gastric-type endocervical carcinoma, fertility sparing management is ‘a priori’ not recommended. Even so, this issue remains undocumented. For this reason, a selected review of the current literature on gastric type endocervical carcinoma was carried out through PubMed. The keywords included “gastric-type cervical cancer”, “gastric-type endocervical carcinoma”, “conservative surgery”, “conservative treatment”, “fertility sparing surgery”, “radical trachelectomy”, “laparoscopic trachelectomy”, “robotic trachelectomy”, “laparotomic trachelectomy”, “abdominal trachelectomy”, “trachelectomy”, “neoadjuvant chemotherapy”, “conisation”, and “cone resection”. A search in the European Network on Cancer, Infertility and Pregnancy (INCIP) database was performed. The rarity of gastric-type endocervical carcinoma does not allow for conclusions on fertility sparing management with solid evidence. However, diffuse character of the disease and aggressive clinical behavior contraindicate a conservative treatment in young women with gastric type cervical cancer.

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Section: Radiologic Featuresmentioning

confidence: 52%

Fertility Sparing Treatment in Gastric-Type Endocervical Carcinoma

Rychlik¹,

Querleu

Bidziński³

2021

Cancers

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“…Karamurzin et al (24) also reported that GMC exhibited significantly worse disease-specific survival than UEA. Similarly, Park et al (29) showed that GMC had a significantly shorter interval between surgery and disease recurrence (time to recurrence) compared to UEA. Overall, GMC exhibits aggressive behavior with significantly reduced survival compared to UEA, and GMC is thus considered a distinct entity from UEA.…”

Section: Discussionmentioning

confidence: 90%

Clinicopathological and Molecular Differences Between Gastric-type Mucinous Carcinoma and Usual-type Endocervical Adenocarcinoma of the Uterine Cervix

Jung

Bae

Kim

et al. 2020

Cancer Genomics Proteomics

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Background/Aim: We investigated differences in the clinicopathological and molecular characteristics between gastric-type mucinous carcinoma (GMC) and usualtype endocervical adenocarcinoma (UEA). Patients and Methods: We collected the clinicopathological information and performed targeted genomic sequencing analysis. Results: GMCs exhibited significantly deeper invasion depth, larger horizontal spread, more advanced stage, more frequent distant metastasis, and more frequent parametrial and vaginal extension. Disease-free survival time of GMC patients was significantly shorter than that of UEA patients. GMCs displayed mutant p53 immunostaining pattern, whereas UEAs exhibited p16 block positivity. GMCs harbored mutations in KRAS, TP53, NF1, CDKN2A, STK11, and ARID1A. One GMC exhibited MDM2 amplification. In contrast, UEAs harbored mutations in HRAS, PIK3CA, and BRCA2. Two UEAs were found to have novel TP53 mutations. Conclusion: GMC is associated with more aggressive behavior than UEA. Distinctive p53 and p16 immunostaining patterns enable differential diagnosis. GMC and UEA exhibit genetic heterogeneity with potentially actionable molecular alterations. Cervical cancer is the fourth most common gynecological malignancy and the fourth leading cause of cancer-related death in women worldwide (1, 2), although cervicovaginal cytology screening decreased the incidence rate of cervical cancer and its associated mortality rate. Adenocarcinoma of the uterine cervix is relatively less common than squamous cell carcinoma and accounts for approximately 10-20% of all cervical cancers (3, 4). However, despite the declined incidence of cervical cancer, the proportion of endocervical adenocarcinoma has increased (4-6). The International Endocervical Adenocarcinoma Criteria and Classification (IECC) is a recent system to classify endocervical adenocarcinoma into human papillomavirus (HPV)-associated adenocarcinoma (HPVA) and non-HPV-associated adenocarcinoma (NHPVA) categories based on morphological features (7). Identification of high-risk HPV, notable mitotic activity, and numerous apoptotic bodies across the glandular lumina allowed diagnosing HPVAs. The HPVAs were further divided into usual type, mucinous type (intestinal type, signet ring cell type, and not otherwise specified), villoglandular type, and invasive stratified mucin-producing carcinoma (invasive stratified mucin-producing intraepithelial lesion), depending on their cytoplasmic mucin component and nuclear characteristics. Meanwhile, NHPVAs include gastric-type mucinous carcinoma (GMC), mesonephric carcinoma, serous carcinoma, clear cell carcinoma, and endometrioid adenocarcinoma. Among these carcinomas, GMC, which is the second most common subtype of endocervical adenocarcinoma, is included in the 2014 World Health Organization (WHO) Classification of Tumours of Female Reproductive Organs (1). Although the incidence of 627 This article is freely accessible online.

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“…The MRI manifestations of GAS are as follows: exogenous or endogenous mass, ill-defined margin, cysts within the tumor, and location in the upper cervical canal or the entire cervix. [7] And T1WI may show low signal intensity, while T2WI shows high signal intensity. In our patient, her abdominal and pelvic MRI showed that the signal intensity on T1WI was slightly low and on T2WI was slightly high of the uterine isthmus, with imaging diagnosis of cervical cancer.…”

Section: Discussionmentioning

confidence: 99%

A case of endocervical adenocarcinoma of the gastric type that was repeatedly misdiagnosed: A case report and literature review

et al. 2023

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Rationale: Gastric-type endocervical adenocarcinoma (GAS) is non-human papillomavirus-associated cervical cancer and the location of the lesions is in the cervical canal mostly.Patient concerns: Vaginal discharge is mistakenly thought to be caused by uterine fibroids. Misdiagnosis leads to disease progression.Diagnoses: Magnetic resonance imaging is an auxiliary tool and pathology is the gold standard for the diagnosis.Interventions: Surgery and supplementary radiotherapy and chemotherapy ± targeted therapy are the main treatment methods.Outcomes: GAS with high malignant degree poor prognosis and insidious development, tends to develop toward the cervical canal and is lack of specific tumor markers, so it is easy to misdiagnosis and missed diagnosis.Lessons: This case highlights the importance of improving the understanding of GAS. And when patients perform vaginal discharge, cervical canal hypertrophy, and cervical cancer screening negative, clinicians ought to be highly alert to GAS.

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Gastric-Type Adenocarcinoma of the Uterine Cervix

Abstract: Gastric-type mucinous adenocarcinoma may have characteristic imaging features and poorer outcomes compared with UEA.

Cited by 21 publications

References 22 publications

Fertility Sparing Treatment in Gastric-Type Endocervical Carcinoma

Fertility Sparing Treatment in Gastric-Type Endocervical Carcinoma

Clinicopathological and Molecular Differences Between Gastric-type Mucinous Carcinoma and Usual-type Endocervical Adenocarcinoma of the Uterine Cervix

A case of endocervical adenocarcinoma of the gastric type that was repeatedly misdiagnosed: A case report and literature review

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