Recurrent Colorectal Carcinoma Detected by Routine Cervicovaginal Papanicolaou Smear Testing

Childs, Alex J.; Burke, James J.; Perry, Michelle Y.; Check, William E; Gallup, Donald G.

doi:10.1097/01.lgt.0000179865.98068.32

Cited by 7 publications

(6 citation statements)

References 19 publications

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“…Metastatic colorectal adenocarcinoma in a cervical smear usually shows clusters of tall, palisaded, malignant columnar cells with elongated nuclei in a haemorrhagic/necrotic background 2,13 . LBC samples as compared with conventional smears may show more tumour microbiopsies with a typical nuclear palisading characteristic of colorectal adenocarcinoma, probably as a consequence of sampling by the cervical brush as was seen in the present case.…”

Section: Discussionsupporting

confidence: 56%

Cytomorphological features of extra‐genital metastases in SurePath™ cervical liquid‐based cytology: a series of eight cases

2012

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Section: Discussionsupporting

confidence: 56%

Cytomorphological features of extra‐genital metastases in SurePath™ cervical liquid‐based cytology: a series of eight cases

2012

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“…The most common primary sites of origin of metastatic carcinomas detected in cervical cytologic samples are the ovary, gastrointestinal tract, and breast. 1 The cells from these extrauterine primaries involve the cervix through 3 possible routes: hematogenous/lymphatic spread, direct extension, or when associated with ascites like ovarian primaries by retrograde flow through the fallopian tubes via the uterine cavity to the cervix. Although the detection of the tumor cells on screening is usually not difficult, correct classification may be.…”

Section: Discussionmentioning

confidence: 99%

Metastatic Colon Carcinoma to the Cervix on Papanicolaou Test: Report of a Case With Cytologic-Histological Correlation

Varghese

Russell

Bonfiglio

2011

Pathology Case Reviews

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Metastatic carcinoma diagnosed on the Papanicolaou test is a rare phenomenon. Herein, we present a case of metastatic colon cancer to the cervix in a 29-year-old woman.We discuss the cytologic-histological correlation, pertinent differential diagnoses, and diagnostic techniques and briefly review the clinical setting of colon cancer.The case is that of a 29-year-old woman with recurrent stage IV colon cancer status after multiple resections and chemotherapy regimens who presented to her gynecologist for an annual examination. She had no gynecologic complaints.A recent positron emission tomographic scan had shown a recurrent cancerous growth in the soft tissue of the presacral space. The patient's primary diagnosis 3 years earlier was poorly differentiated colon adenocarcinoma with mucinous and signet ring cell differentiation, which involved the ileocecal valve with extension into the ileum and cecum. The cancer showed lymphovascular invasion with involvement of 8 lymph nodes as well as the pelvic peritoneal soft tissue. Her family history was relevant for cancers on the maternal side; her mother had renal cell cancer and both maternal grandparents had colon cancer.The liquid-based cervical cytology slide showed numerous hyperchromatic crowded cell groups. A fair number of these groups showed glandular architecture with moderate amount of granular cytoplasm, eccentric nuclei, and prominent nucleoli (Figs. 1 and 2). Some 3-dimensional cell groups showed overlapping cell nuclei with round to oval nuclear contours, nuclear irregularities, and coarse granular dark chromatin. There were marked nuclear size variability, some mitotic figures, and rare cells with intracytoplasmic vacuolation. The cell groups lacked the feathery edges and palisading usually seen with endocervical adenocarcinoma as well as the cytoplasmic features suggestive of squamous intraepithelial lesions. The background showed granular debris, some of which was clinging to the malignant tumor cells.A CDX2 immunohistochemical stain was performed on an unstained ThinPrep (Hologic, Bedford, Mass) slide using standard methods as well as an appropriate control. The hyperchromatic crowded cell groups were moderately to strongly positive for CDX2 (Fig. 3). A diagnosis of adenocarcinoma consistent with colonic primary was rendered on the cervical cytology specimen.The follow-up cervical biopsy showed complete replacement of cervical epithelium and subepithelial soft tissue by the tumor, which was composed of malignant glandular fragments floating within a mucinous background (Fig. 4). As in the cytology specimen, there was marked anisonucleosis with nuclear irregularities; the cytoplasm was granular, with some cells showing prominent intracytoplasmic mucin vacuoles and signet ring morphology. The immunohistochemical staining on the biopsy showed CK7 negativity and CK20 positivity (Fig. 5). The biopsy was compared and found to be similar to the original primary cancer of the colon (Fig. 6). The biopsy was signed out as adenocarcinoma with mucinous and signet ...

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“…Recurrence of colorectal carcinoma usually occurs within 5 years after surgery [4]. Most cases of uterine cervical metastasis from colorectal carcinoma have penetrated the wall of the bowel at the time of first surgery (Dukes stage B), or spread to the regional lymph nodes (Dukes stage C) [6] [8].…”

Section: Discussionmentioning

confidence: 99%

“…Metastatic carcinoma of the uterine cervix from colorectal carcinoma is very rare, and only 35 cases have been reported in the literature since 1941 [4]- [17]. The patients' ages ranged from 17 -77 years [9], with an average age of 56.5 years.…”

Section: Discussionmentioning

confidence: 99%

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Metastatic Carcinoma of the Uterine Cervix from Rectal Carcinoma: A Case Report and Review of the Literature

Matsuura¹,

Tamate²,

Suzuki³

et al. 2014

OJOG

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Primary adenocarcinomas of the uterine cervix account for 5% -15% of all cervical malignancies, but secondary adenocarcinomas from extragenital cancers are rare. Only 35 cases have been reported in the literature since 1941. We report a 52-year-old Japanese woman who had been treated for rectal adenocarcinoma (Dukes C, stage IIIb) and who was diagnosed with primary uterine cervical carcinoma (FIGO stage Ib2) two years later. A radical hysterectomy was performed and the surgical specimen showed metastatic adenocarcinoma of the uterine cervix from rectal cancer without direct extension. Immunohistochemical staining was positive for cytokeratin 20 and CDX2, and negative for cytokeratin 7. Immunohistochemical staining is important for distinguishing between primary and secondary adenocarcinomas of the cervix, but histologic findings alone are not always adequate to establish the site of the primary lesion. The distinction between primary and secondary adenocarcinomas of the cervix is important for patient management and prognosis. Therefore, the possibility of metastatic adenocarcinoma should be considered whenever a diagnosis of adenocarcinoma of the cervix is received. KeywordsMetastatic Adenocarcinoma, Cervical Cancer, Colorectal Carcinoma M. Matsuura et al. 618

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Recurrent Colorectal Carcinoma Detected by Routine Cervicovaginal Papanicolaou Smear Testing

Abstract: In patients with a history of extrauterine adenocarcinoma, abnormal Pap screening may indicate recurrent or metastatic carcinoma.

Cited by 7 publications

References 19 publications

Cytomorphological features of extra‐genital metastases in SurePath™ cervical liquid‐based cytology: a series of eight cases

Cytomorphological features of extra‐genital metastases in SurePath™ cervical liquid‐based cytology: a series of eight cases

Metastatic Colon Carcinoma to the Cervix on Papanicolaou Test: Report of a Case With Cytologic-Histological Correlation

Metastatic Carcinoma of the Uterine Cervix from Rectal Carcinoma: A Case Report and Review of the Literature

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