Cervical clear cell adenocarcinoma with an exceptionally low proliferation index: Report of a case

Abstract

HighlightsA histologically low-grade cervical clear cell lesion was observed.Proliferating cells were seen only at the periphery of this lesion.Due to its low proliferation index, this may represent a precursor of clear cell carcinoma.Further definition of such lesions may allow for more minimal management.

Precursor Lesions of Cervical Clear Cell Carcinoma: Evidence For Origin From Tubo-Endometrial Metaplasia

“…The presence or absence of TEM was not mentioned. The authors speculated that this could represent a benign counterpart of CCC, putatively termed “clear cell hyperplasia,” and thereby a possible tumor precursor 17. However, we would regard this as a small CCC similar to the 3 “early” CCCs we report rather than a precursor lesion.…”

“…A further recent report describes a small “low grade” tumor in the cervix with morphologic features of CCC but lacking proliferative activity or widespread atypia 17. This lesion exhibited tubulocystic architecture with a single-layered epithelial lining of predominantly nonatypical cells.…”

“…Unlike DES-associated tumors, which usually arise in the ectocervix, sporadic cases typically involve the endocervix and transformation zone (12). Limited data suggest that the prognosis of cervical CCC is similar to stage-matched squamous cell carcinoma and HPV-associated adenocarcinoma (12,(17)(18)(19)(20).…”

“…the cases we report given the deep location of the tumors and likely have a similar pathogenesis to extrauterine CCC, with deep cervical endometriosis being analogous to endometriosis at extrauterine sites. A further recent report describes a small "low grade" tumor in the cervix with morphologic features of CCC but lacking proliferative activity or widespread atypia (17). This lesion exhibited tubulocystic architecture with a single-layered epithelial lining of predominantly nonatypical cells.…”