Mucoepidermoid Carcinoma of the Uterine Cervix—Single-Center Study Over a 10-Year Period

Abstract

Background and objectives: Adenosquamous cancer of the uterine cervix is a rare type of cervical cancer with both malignant squamous and glandular components. A very rare subtype is mucoepidermoid carcinoma (MEC), which was first described as a salivary gland tumor. It has been described as having the appearance of a squamous cell carcinoma without glandular formation and contains intracellular mucin. The postoperative evolution of this tumor and the potentially poorer prognosis may indicate an intensification of the follow-up. The objective of our study was to analyze the frequency of mucoepidermoid carcinoma in hospitalized women with cervical cancer, clinical characteristics and prognosis. Material and Methods: A retrospective study of all cases of mucoepidermoid carcinoma of the cervix at Department of Gynecologic Oncology, University Hospital—Pleven, Pleven Bulgaria between 1 January 2007 and 31 December 2016 was performed. All patients were followed-up till December 2019. We analyzed certain clinical characteristics of the patients; calculated the frequency of mucoepidermoid carcinoma of the cervix from all patients with stage I cervical cancer; and looked at the overall survival rate, correlation between overall survival, lymph node status and the size of the tumor. Results: The frequency of MEC was 1.12% of all patients with stage I cervical cancer in this study. The median age of the patients with MEC was 46.7 years (range 38–62). Four patients (57.1%) were staged as FIGO IB1, and three patients (42.8%) were FIGO IB2. The size of the primary tumor was <2 cm in 2 patients (28.57%), 2–4 cm in 2 patients (28.57%) and >4 cm in 3 patients (42.8%). Metastatic lymph nodes were found in two patients (28.57%), and nonmetastatic lymph nodes were found in five patients (71.43%). There were two (28.57%) disease-related deaths during the study period. The five-year observed survival in the MEC group was 85.7% and in the other subtypes of adenosquamous cancer group was 78.3%. Conclusions: MEC of the uterine cervix is a rare entity diagnosis. As a mucin-producing tumor, it is frequently regarded as a subtype with worse clinical behavior and patients’ outcomes. Nevertheless, our data did not confirm this prognosis. New molecular markers and better stratification are needed for better selection of patients with CC, which may benefit more from additional treatment and new target therapies.

Колко Редки Са Редките Онкологични Болести?

“…По тази причина те не могат да бъдат представителни за България, но са най-голямата база данни, публикувана и анализирана до момента в България. В четири от статиите [13][14][15][16] обект на публикация са карциномите на маточната шийка с редки хистологични подвидове. Описани са техните морфологичнобиологични особености и значението им за клиничното поведение, като това е и най-голямата серия случаи, публикувани в литературата относно редки хистологични подвидове като lymphoepithelioma-like carcinoma (LELC) [14,17], мукоепидермоидния -MEC [16] и warty карцинома [13] на маточната шийка.…”

“…В четири от статиите [13][14][15][16] обект на публикация са карциномите на маточната шийка с редки хистологични подвидове. Описани са техните морфологичнобиологични особености и значението им за клиничното поведение, като това е и най-голямата серия случаи, публикувани в литературата относно редки хистологични подвидове като lymphoepithelioma-like carcinoma (LELC) [14,17], мукоепидермоидния -MEC [16] и warty карцинома [13] на маточната шийка. Честотата на тези карциноми е относително ниска, съответно 3.03%, 1.12% и 2.2%.…”

“…Честотата на тези карциноми е относително ниска, съответно 3.03%, 1.12% и 2.2%. Интересен е анализът за преживяемост сред тези пациентки като подобно на данните за редки онкогинекологични тумори, преживяемостта сред тези редки подвидове карциноми на маточна шийка е сходна с тази на нередките карциноми [13][14]16].…”

“…Обобщението на данните от България в погорецитираните публикации [12][13][14][15][16][17] допринася за по-лесно идентифициране на множество редки болести и дава възможност за тяхното адекватно лечение без допълнително забавяне поради редкия хистологичен подвид.…”