Metastatic adenocarcinoma to the uterine cervix from gastric cancer. A clinicopathologic analysis of 16 cases

Abstract

Background. Metastatic adenocarcinoma to the uterine cervix from gastric cancer is rare, and the clinicopathologic features of this metastasis are unclear. Methods. A clinicopathologic review of 16 patients with metastatic adenocarcinoma to the uterine cervix from gastric cancer was performed. Results. The ages of the patients ranged from 29 to 57 years, and 81.3% of the patients were premenopausal. Nine of the patients had undergone gastrectomy previously. In 11 patients the histologic type of the gastric cancer was poorly differentiated adenocarcinoma and, in 5 patients, signet ring cell carcinoma. The cervical metastasis was diagnosed 11–121 months (mean, 57.5 months) after the diagnosis of the gastric cancer in 10 of the patients. In six patients, the cervical metastasis was discovered synchronously or before the diagnosis of the gastric cancer. The colposcopic findings were normal in 57.1%, but 56.3% had abnormal cervical smears. In all patients, tumor cells were present in the dilated lymphatics of the cervix. Metastases to the uterine body and bilateral ovaries were common, and half of the patients had metastases to the paraaortic lymph nodes. Extirpation of the cervix was performed in six patients. The prognosis was poor, regardless of the treatment method. Conclusions. The route of metastasis to the cervix is surmised to be retrograde lymphatic, and this extension is often slow. Periodic gynecologic examinations should be performed indefinitely for premenopausal female patients with advanced gastric cancer.

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

“…Mucinous adenocarcinoma of the uterine cervix has subtypes: endocervical, intestinal, and signet-ring cell [4]. Signet-ring cell adenocarcinoma in the female genital tract most commonly involves the ovary and mostly presents a metastasis from the stomach [2]. In the literature, primary signet-ring cell carcinoma of cervix is extremely rare [5].…”

“…The current frequency of cervical adenocarcinoma is 15-20% of all cervical carcinomas and most of them are endocervical type [1]. Adenocarcinomas with signet ring cell are mostly metastatic from gastric, breast, colonic or ovarian carcinomas and primary tumor is extremely rare [2][3][4]. We describe an unusual case of woman with having primary signet ring cell carcinoma of the uterine cervix.…”

Metastatic gastric cancer to the female genital tract

“…In these cases, however, the patients could be asymptomatic, without uterine bleeding (28). Genital bleeding is also the most frequent symptom, followed by ascites and lower abdominal pain, in women with metastasis from gastric cancer to the uterine cervix (43). Rarely, metastasis to the uterine cervix from gastric cancer presents with ureteral obstruction (30,44), although it is extremely rare for these lesions to be found at the metastatic site mimicking advancedstage disease (International Federation of Gynecology and Obstetrics stage IIIB).…”

“…Histologically, metastatic carcinoma to the uterine corpus is characterized by focal occurrence, lack of necrosis and the lack of accompanying premalignant changes in the endometrium (49). As regards metastatic adenocarcinoma to the uterine cervix from gastric cancer, Imachi et al (43) reviewed 16 patients and reported that 9/16 (56.3%) patients exhibited abnormal cytological findings. However, 8/14 (57.1%) of the patients showed no abnormal findings on colposcopy.…”

Metastatic signet ring cell gastric carcinoma presenting as an infrarenal aortic aneurysm

“…Occasionally, metastases to other organs, such as the prostate gland [1], the gluteal muscle [2], or the cervix [3] are described. To our knowledge, this is the first report of the lymphogenic metastasis of a signet ring cell gastric carcinoma to an aortic aneurysm.…”