Primary signet ring cell carcinoma of the cervix is extremely rare. A 47-year-old woman visited for postcoital vaginal bleeding during the last six months. Gynecologic examination revealed mild cervical erosion and touch bleeding. Colposcopic punch biopsy revealed a signet ring cell type of mucinous adenocarcinoma. The patient underwent radical hysterectomy with bilateral salpingooophorectomy, pelvic lymph node dissection, and para-aortic lymph node dissection. Microscopically, the tumor mainly consisted of two different types of cells; mixed signet ring cell carcinoma (70%) and mucinous carcinoma of intestinal type (30%). The patient died in 6 months after operation. The prognosis of primary signet ring cell adenocarcinoma of the uterine cervix is still unclear because of the extremely rare incidence of cases. In this case, we could suggest that this type of carcinoma has an aggressive behavior.Keywords: Signet ring cell carcinoma, Uterine cervical neoplasm, Adenocarcinoma Copyright © 2011. Korean Society of Obstetrics and GynecologyCarcinoma of the uterine cervix is the most common malignancy in female genital tract, and squamous cell carcinoma is the commonest of them. Adenocarcinomas of the uterine cervix have increased in both relative and absolute frequency. 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. Case ReportA 47-year-old woman, gravida 5, para 4, visited her gynecologist for postcoital vaginal bleeding during the last six months. She denied ever taking oral contraceptives and never complained of gastrointestinal symptoms. Gynecologic examination revealed mild cervical erosion and touch bleeding. The physician decided to perform a cervical cytologic examination and endocervical curettage. Histopathologic examination of the former showed poorly differentiated carcinoma of undetermined type and the latter showed small cell carcinoma. Colposcopic punch biopsy was done and the result was a signet ring cell type of mucinous adenocarcinoma.The results of laboratory studies including analysis of tumor markers were all within normal limits (squamous cell carcinoma related antigen 0.8 ng/mL, CA-125 17.3 U/mL, carcinoembryonic antigen [CEA] 1.0 ng/mL). Human papilloma virus (HPV) type 18 and 16 were negative. We tried to find an extragenital primary tumor. Abdominopelvic magnetic resonance imaging (MRI) demonstrated about 5×10 mm size mass in the endocervical canal and did not demonstrate any possibility of metastatic tumor or tumor derived from other origins. Whole body positron emission tomography showed only increased fl urodeoxyglucose uptake along the deep portion of endocervical canal suggesting malignant tissue but no other abnormal fi nding. Korean J Obstet ...

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Gestational trophoblastic neoplasm (GTN) is prone to pulmonary metastasis. Although most pulmonary metastatic lesions response with chemotherapy, some lesions do not resolve and persist on radiologic investigations. A 25-year-old women was referred for persistent pulmonary metastatic lesion of GTN. Here, we present a case of chemo-resistant choriocarcinoma metastatic to lung managed by video-assisted thoracoscopic surgery.Key Words: Gestational trophoblastic neoplasm, Thoracic surgery, Video-assistedGestational trophoblastic neoplasm (GTN) tends to hematogenous metastasis, especially to the lungs.After several courses of chemotherapy, residual pulmonary lesions have to be managed with further treatments.The role of surgery for pulmonary metastasis is not fully defined. Thoracotomy sometimes has played a role in the management of pulmonary metastasis.Prior series have reported a wide range for the rate of surgery for pulmonary metastasis in choriocarcinoma ranging from 1% to 17%. 1As a result of advances in surgical technique, resection of pulmonary metastasis can be accomplished in a less invasive manner with thoracoscopic surgery.We present a case of chemo-resistant choriocarcinoma metastatic to lung managed by video-assisted thoracoscopic surgery. Case reportThe patient is 25-year-old gravida 2 para 0 women. She had a past history of two spontaneous abortion. She visited to a local clinic in 1/25/2005 for amenorrhea for 7 weeks. Her serum β-human chorionic gonadotropin (β-hCG) was 311 mIU/mL. On pelvic ultrasonography, she had a normal appearance of uterus, fallopian tubes, and ovary. Based on the