Adenocarcinoma: A unique cervical cancer

Gien, Lilian T.; Beauchemin, Marie-Claude; Thomas, Gillian

doi:10.1016/j.ygyno.2009.09.040

Cited by 235 publications

(215 citation statements)

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“…In clinical setting, complete history and work up are needed to exclude the possibility of metastatic lesion. Although some studies have shown no differences in survival between adenocarcinoma and squamous cell carcinoma, the majority have shown that adenocarcinoma carries a worse prognosis with 10-20% difference in 5-year overall survival rates [7]. The prognosis of primary signet-ring cell adenocarcinoma of the cervix is not well known as a result of the small number of case reports.…”

Section: Discussionmentioning

confidence: 99%

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

Yoon

Kim

et al. 2011

Korean J Obstet Gynecol

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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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Section: Discussionmentioning

confidence: 99%

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

Yoon

Kim

et al. 2011

Korean J Obstet Gynecol

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“…Based on the results of randomized clinical trials, concurrent chemoradiotherapy (CCRT) has become the primary treatment for stage IB2 to IVA disease (9,10). Only a few studies have assessed specific treatments for cervical adenocarcinomas, but they are typically treated in a similar manner to cervical squamous cell carcinomas (11).…”

Section: Introductionmentioning

confidence: 99%

Human papillomavirus genotype affects metastatic rate following radiotherapy in patients with uterine cervical cancer

et al. 2017

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Abstract. Human papillomavirus (HPV) infection is well known as a major etiological risk factor associated with carcinogenesis in uterine cervical cancer. However, few reports have investigated the association between HPV genotype and outcome in patients with uterine cervical cancer following radiotherapy (RT). The aim of the present study was to investigate the association between the HPV genotype and clinical outcome following RT in Japanese patients with uterine cervical cancer. Between November 2001 and August 2006, 157 Japanese women with uterine cervical cancer were treated with RT or concurrent chemoradiotherapy with curative intent. Pretreatment, formalin-fixed, paraffin-embedded biopsies were obtained from 83 patients. HPV genotypes were determined using the polymerase chain reaction method. Patients were categorized, according to HPV L1 protein sequence homology, into the HPV α-9 (HPV 16,31,33, 52, and 58),39, 45, 59, and 68) or 'other' (HPV 51 and 56) groups. Associations between HPV genotype and clinical outcome following RT were evaluated. A total of 54 (65.1%) tumors were HPV α-9-positive, 13 (15.7%) were HPV α-7-positive, 2 (2.4%) were categorized under 'other' and 14 (16.9%) were HPV-negative. There were no significant differences in age, FIGO stage, regional lymph node metastases rate at diagnosis, or concurrent chemotherapy administration between the HPV α-9 and α-7 groups. The median follow-up period was 52 months (range, 2-156 months). The 5-year disease-free survival rates were 54.5 and 30.8% in the HPV α-9 and α-7 groups, respectively (P=0.034), and the 5-year distant metastasis rates were 38.0 and 69.2%, respectively (P=0.015). There were no significant differences in the 5-year local control or overall survival (OS) rates between the two groups. HPV genotype affected the 5-year distant metastatic rate, however not the 5-year local control or OS rate in patients with uterine cervical cancer following RT. IntroductionUterine cervical cancer (CC) is the second most common cancer among women, worldwide (1). The annual global incidence of CC in 2012 was 528,000 cases, and the annual global mortality rate was 266,000 deaths, with 85% of cases occurring in developing countries, where CC is a leading cause of cancer-related death in women (2). Oncogenic type human papillomavirus (HPV) infection is a major etiologic risk factor (3) associated with carcinogenesis (4). More than 100 HPV types have been identified, with a subset of these being classified as high risk. HPV 16 and HPV 18 are the most commonly detected genotypes occurring in 71% of invasive CCs (5). Current detection methods have uncovered a HPV prevalence of 95-100% in women with CC (6,7).The primary treatment strategy for uterine CC consists of surgery or radiotherapy (RT). Surgery is typically reserved for early-stage disease and small lesions including stage IA, IB1, and selected IIA1 diseases (8). Based on the results of randomized clinical trials, concurrent chemoradiotherapy (CCRT) has become the primary treatment for stage IB2...

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“…HPV-associated adenocarcinomas have accounted for 20% of cervical cancer in North American women during recent years. 4 Importantly, HPV infection is also associated with rectal adenocarcinoma. 5 Therefore, the recent increases in the prevalence of anal sex may well underlie, in part, the concurrent increases in rectal cancer in young Americans.…”

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Receptive anal intercourse as a potential risk factor for rectal cancer

Potterat¹,

Brewer

Brody

2011

Cancer

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In reporting an increase in rectal cancer incidence among young (aged <40 years) Americans during the last quarter century, Meyer and colleagues 1 call for further investigation of risk factors, especially of interactions among environmental factors and changing population genetics resulting from the shifting demographics in the United States. In our view, candidate environmental factors should include anal sexual behaviors, especially receptive anal intercourse, that can deposit potentially immunosuppressive (eg, semen) or carcinogenic (eg, sexually transmissible pathogens) foreign antigens.Receptive anal intercourse is associated with anal cancer.2 Human papilloma virus (HPV), presumably transmitted through anal intercourse, is also considered the main cause of anal cancer.2 The prevalence of anal intercourse in heterosexuals in the United States has increased during the last 20 years, 2 and the incidence of anal cancer has similarly increased for women and men in all age groups in the United States during the same period.3 HPV infection may cause both squamous cell carcinoma (the predominant form of anal cancers) and adenocarcinoma (the predominant form of rectal cancer). HPV-associated adenocarcinomas have accounted for 20% of cervical cancer in North American women during recent years.4 Importantly, HPV infection is also associated with rectal adenocarcinoma.5 Therefore, the recent increases in the prevalence of anal sex may well underlie, in part, the concurrent increases in rectal cancer in young Americans.Assessing history and frequency of receptive anal intercourse should be a priority both at rectal cancer diagnosis and in epidemiologic research on rectal cancer. We realize that asking potentially embarrassing questions may be difficult for clinicians and cancer researchers. In our experience, asking such questions in a nonapologetic, nonjudgmental tone considerably attenuates patient-provider discomfort. When such investigations reveal an association between receptive anal intercourse and rectal cancer, then screening and prevention messages should be augmented by an additional focus on receptive anal intercourse. REFERENCES1. Meyer JE, Narang T, Schnoll-Sussman FH, Pochapin MB, Christos PJ, Sherr DL.

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Adenocarcinoma: A unique cervical cancer

Cited by 235 publications

References 57 publications

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

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

Human papillomavirus genotype affects metastatic rate following radiotherapy in patients with uterine cervical cancer

Receptive anal intercourse as a potential risk factor for rectal cancer

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