Magnetic Resonance Appearance of Gastric-Type Adenocarcinoma of the Uterine Cervix in Comparison With That of Usual-Type Endocervical Adenocarcinoma: A Pitfall of Newly Described Unusual Subtype of Endocervical Adenocarcinoma

Kido, Aki; Mikami, Yoshiki; Koyama, Takashi; Kataoka, Masako; Shitano, Fuki; Konishi, Ikuo; Togashi, Kaori

doi:10.1097/igc.0000000000000229

Cited by 30 publications

(26 citation statements)

References 14 publications

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“…The present study indicates that this is not always true because some cystic components on MR images consisted of gastric‐type mucinous carcinoma (Patients 1, 5, and 7). In addition, cystic components associated with tumors were identified in only 0.025% of cases of squamous cell carcinoma but occurred in 80% of cases of gastric‐type mucinous carcinoma . Hence, a cystic component is common in gastric‐type mucinous carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Uterine cervical adenocarcinoma associated with lobular endocervical glandular hyperplasia: Radiologic–pathologic correlation

Ohya

Asaka

Fujinaga

et al. 2017

J of Obstet and Gynaecol

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Section: Discussionmentioning

confidence: 99%

Uterine cervical adenocarcinoma associated with lobular endocervical glandular hyperplasia: Radiologic–pathologic correlation

Ohya

Asaka

Fujinaga

et al. 2017

J of Obstet and Gynaecol

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“…Kido et al (9) reported that tiny cysts associated with tumors were observed in 80% of the cases of gastric-type endocervical adenocarcinoma on MRI. The tumors in cases 1 and 2 displayed cystic regions on MRI, while in the case FIGO, International Federation of Gynecology and Obstetrics; MRI, magnetic resonance imaging; PFS, progression-free survival; OS, overall survival; CEA, carcinoembryonic antigen; CA19-9, carbohydrate antigen 19-9; MUC, mucin; TAH, total abdominal hysterectomy; BSO, bilateral salpingo-oophorectomy; PeN, pelvic lymphadenectomy; PAN, para-aortic lymphadenectomy; OM, omentectomy; RH, radical hysterectomy; NED, no evidence of disease; DOD, dead of disease.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging findings and prognosis of gastric-type mucinous adenocarcinoma (minimal deviation adenocarcinoma or adenoma malignum) of the uterine corpus: Two case reports

Hino

Yamaguchi

Abiko

et al. 2016

Molecular and Clinical Oncology

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Abstract. Our group previously documented the first, very rare case of primary gastric-type mucinous adenocarcinoma of the uterine corpus. Although this type of endometrial cancer appears to be similar to the gastric-type adenocarcinoma of the uterine cervix, its main symptoms, appearance on magnetic resonance imaging (MRI) and prognosis have not been fully elucidated due to its rarity. We herein describe an additional case of gastric-type mucinous adenocarcinoma of the endometrium and review the relevant literature. The two cases at our institution (Kyoto University Hospital, Kyoto, Japan) involved postmenopausal women with a primary complaint of abnormal genital bleeding. Microscopic examination of the hysterectomy specimens indicated a highly differentiated mucinous adenocarcinoma with a desmoplastic stromal reaction. Immunohistochemistry for HIK1083 and̸or MUC6 was positive in both cases, suggesting a gastric phenotype. Both patients were diagnosed at an advanced stage, they relapsed or recurred immediately after adjuvant chemotherapy, and eventually succumbed to the disease. The main symptom of gastric-type mucinous adenocarcinoma of the uterine cervix is watery discharge, whereas abnormal genital bleeding in addition to watery discharge is mainly observed in the mucinous type of endometrial adenocarcinoma. Cystic cavities in the tumor are present on MRI in cases of endometrial origin, and prognosis is very poor due to resistance to chemotherapy. Thus, gastric-type mucinous adenocarcinoma of the uterine endometrium exhibits a clinical behavior that is similar to tumors originating from the uterine cervix, but is associated with distinguishing clinical symptoms. The incidence of gastric-type endometrial adenocarcinoma may be higher than expected.

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“…They showed that GAS was diagnosed at an advanced stage, with 59% of cases being stage II or higher, with frequent lymph node metastasis, ovarian involvement, intra‐abdominal spread, and distant metastasis. Radiologically and grossly, GAS commonly shows highly infiltrative and endophytic growth without forming exophytic or bulky well‐demarcated masses . Therefore, clinical stage may be underestimated.…”

Section: Gastric‐type Adenocarcinoma: Expansion Of the Category Beyonmentioning

confidence: 99%

“…Radiologically and grossly, GAS commonly shows highly infiltrative and endophytic growth without forming exophytic or bulky well-demarcated masses. 58 Therefore, clinical stage may be underestimated. The worse prognosis may, to some extent, be attributed to an advanced stage at the time of diagnosis, but patients with stage I GAS show lower 5-year disease-specific survival than those with stage I UEA.…”

Section: Gastric-type Adenocarcinoma: Expansion Of the Category Beyonmentioning

confidence: 99%

Gastric‐type mucinous carcinoma of the cervix and its precursors – historical overview

Mikami

2019

Histopathology

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The emerging concept of gastric‐type mucinous carcinoma (GAS) of the uterine cervix has been accepted worldwide because of its aggressive clinical behaviour and the absence of high‐risk human papillomavirus (HPV). GAS is included as a variant of mucinous carcinoma in the 2014 World Health Organization classification, and its recognition has provoked a discussion on endocervical adenocarcinoma as a single entity such that endocervical adenocarcinoma is now divided into HPV‐associated and HPV‐independent groups. This article reviews historical and conceptual aspects of GAS and its precursors, starting with minimal deviation adenocarcinoma (MDA), through the ensuing confusion, up to the recent paradigm shift in cervical adenocarcinoma subclassification. The gastric immunophenotype of MDA was demonstrated by a Japanese group in 1998 using the HIK1083 antibody, which recognises gastric pyloric gland mucin, and this elucidated the pathogenesis of this particular tumour. However, this information resulted in overdiagnosis of lobular endocervical glandular hyperplasia (LEGH), first described in 1999 and which represents pyloric gland metaplasia (PGM), as malignant. In the early 2000s the relationship between MDA and LEGH/PGM became a matter of controversy. In 2007 HIK1083 immunohistochemistry extended the morphological spectrum of endocervical adenocarcinoma showing gastric differentiation beyond MDA, which resulted in the proposal of GAS as a distinct entity including MDA as its very well‐differentiated subtype. GAS is now considered to be an aggressive and chemoresistant neoplasm that is not related to high‐risk HPV. The LEGH/PGM–GAS sequence is currently regarded as an HPV‐independent pathway of carcinogenesis. Understanding the underlying molecular events in this process is key to the development of biomarkers for early detection and molecular targeted therapy.

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Magnetic Resonance Appearance of Gastric-Type Adenocarcinoma of the Uterine Cervix in Comparison With That of Usual-Type Endocervical Adenocarcinoma: A Pitfall of Newly Described Unusual Subtype of Endocervical Adenocarcinoma

Abstract: Distinctive MR imaging features of GAS were infiltrating mass of endophytic growth, location in the upper cervical canal, and association with tiny cysts. This characteristic appearance can be a clue for the evaluation of extent of tumor based on MR imaging.

Cited by 30 publications

References 14 publications

Uterine cervical adenocarcinoma associated with lobular endocervical glandular hyperplasia: Radiologic–pathologic correlation

Uterine cervical adenocarcinoma associated with lobular endocervical glandular hyperplasia: Radiologic–pathologic correlation

Magnetic resonance imaging findings and prognosis of gastric-type mucinous adenocarcinoma (minimal deviation adenocarcinoma or adenoma malignum) of the uterine corpus: Two case reports

Gastric‐type mucinous carcinoma of the cervix and its precursors – historical overview

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