Clear-cell adenocarcinoma of the uterine cervix in a 17-year-old adolescent

Yabushita, Hiromitsu; Kanyama, Kouhei; Sekiya, Rinko; Noguchi, M.; Wakatsuki, Akihiko

doi:10.1007/s10147-008-0781-3

Cited by 17 publications

(10 citation statements)

References 12 publications

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“…There have been two published cases of clear cell adenocarcinoma of the cervix diagnosed on Pap smear (TPPT) in patients younger than 20 (19 and 17 year of age), but no well defined cases of a classic ECA. 10,19 Interestingly, one of the cases was also negative for HPV via HPV in situ Hybridization. 10 In contrast to the other cases, our patient also had lymph node metastases to three pelvic nodes.…”

Section: Discussionmentioning

confidence: 95%

ThinPrep Pap test of endocervical adenocarcinoma with lymph node metastasis: Report of a case in a 17‐year‐old woman

Wagner

Weisensel

Mentrikoski

et al. 2010

Diagnostic Cytopathology

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Endocervical adenocarcinoma is an uncommon malignancy that is composed of multiple subtypes and accounts for approximately 15% of all cervical cancers. In this article, we describe the cytomorphology and differential diagnosis of an AJCC clinical stage IIIb, FIGO IB2 endocervical adenocarcinoma in a 17-year-old woman in a ThinPrep Pap test.The patient was a 17-year-old G0P0 white woman with no significant past medical history and no prior history of cervical dysplasia. She presented to her physician with a putrid vaginal discharge. A sample was sent to cytology that was interpreted as atypical endocervical cells, favor neoplasia. A subsequent cervical biopsy was diagnosed as endocervical adenocarcinoma with villoglandular features and ultimately, a hysterectomy with lymph node dissection was performed. The final diagnosis was endocervical adenocarcinoma with metastasis to three pelvic lymph nodes.The cytomorphology of endocervical adenocarcinoma on ThinPrep Pap test is similar to that described for conventionally-processed Pap smears. This difficult diagnosis should be considered on a ThinPrep Pap test, regardless of age when the characteristic cytomorphology is observed. On a cytology sample, it is advisable to state atypical endocervical cells, adenocarcinoma in situ, or endocervical adenocarcinoma without providing a specific subtype even if there is a predominance of features for a particular subtype.

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Section: Discussionmentioning

confidence: 95%

ThinPrep Pap test of endocervical adenocarcinoma with lymph node metastasis: Report of a case in a 17‐year‐old woman

Wagner

Weisensel

Mentrikoski

et al. 2010

Diagnostic Cytopathology

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“…CCAUC is a very rare condition [1][2][3][4]. According to the WHO blue book [6], clear cell adenocarcinoma is defined as a malignant tumor composed of glycogen-rich clear cells and hobnail cells and occasionally other cell types [6].…”

Section: Discussionmentioning

confidence: 99%

“…Several cases have been reported in the literatures [1][2][3][4], but no comprehensive reports using a large series have been published. In the past, this tumor was associated with in utero exposure to diethylstilbestrol (DES) [2].…”

Section: Introductionmentioning

confidence: 95%

Clear cell adenocarcinoma of the uterine cervix in a young pregnant woman: a case report with immunohistochemical study

Terada

2010

Med Oncol

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The patient was a 30-year-old-pregnant woman (para 1, gradiva 1) without in utero exposure to diethylstilbestrol. A papillary and flat lesion was found by colposcopy in the uterine cervix in the routine examination at 10 pregnancy weeks. Biopsies showed papillary and tubular proliferation of malignant cells with clear glycogen-rich cytoplasm and malignant hobnail cells and were diagnosed as clear cell adenocarcinoma. The patient was treated by radical hysterectomy. The lesion of the cervix (10 × 15 × 5 mm) was clear cell adenocarcinoma with mild invasion into shallow myometrium (pTIb). An immunohistochemical study showed that the tumor cells were positive for pancytokeratins (AE1/3, CAM5.2, KL-1, and polyclonal wide), cytokeratin (CK) 7, CK8, CK18, CK19, epithelial membrane antigen, CA 125, p53 protein, and Ki-67 antigen (labeling = 95%). The tumor cells were negative for high-molecular weight CK (34βE12), CK5/6, CK14, CK20, vimentin, AFP, CEA, desmin, S100 protein, α-smooth muscle antigen, CD34, estrogen receptor, progesterone receptor, chromogranin, synaptophysin, neuron-specific enolase, and CD56. The patient is now of free of tumor. In the English literature, the present case is the second case of cervical clear cell adenocarcinoma during pregnancy, and the first case of cervical clear cell carcinoma investigating a wide range of immunoreactive antigens.

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“…(1,4) We herein report an extremely rare case of a patient with cervical CCAC without DES exposure. A ten-year-old girl presented with a history of intermittent bloodstained discharge of one year.…”

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confidence: 94%

Clear cell adenocarcinoma of the cervix in a ten-year-old girl without prenatal diethylstilbestrol exposure

Asri¹,

B.K.Lim²,

Lim³

et al. 2016

smedj

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470 L e t t e r t o t h e E d i t o rDear Sir, Cervical clear cell adenocarcinoma (CCAC) accounts for 3%-10% of adenocarcinoma of the uterine cervix cases (1,2) and is often associated with diethylstilbestrol (DES) exposure in utero.(3) CCAC of the uterine cervix is uncommon in adolescents and only a few such cases have been reported. (1,4) We herein report an extremely rare case of a patient with cervical CCAC without DES exposure. A ten-year-old girl presented with a history of intermittent bloodstained discharge of one year. She was only referred to a gynaecologist after a failure to respond to hormone therapy within one year. Physical examination revealed a palpable pelvic mass that was about the size of a gravid uterus of 14 weeks, with visible tissue protruding through the introitus. Magnetic resonance imaging showed a huge mass arising from the cervix of a rudimentary uterus and pushing the pelvic organs toward the abdomen (Fig. 1). There was no evidence of organomegaly or enlarged lymph nodes. The upper and lower urinary tracts appeared normal. Biopsy confirmed the diagnosis of Stage IB2 CCAC of the uterine cervix (Fig. 2). The patient underwent radical abdominal hysterectomy and bilateral pelvic lymph node dissection, followed by six cycles of carboplatin and paclitaxel. Subsequently, pelvic examination under anaesthesia, vault cytology and computed tomography of the abdomen and pelvis were performed. Unfortunately, the patient developed recurrence in her lungs and brain. She and her family declined further treatment and the patient succumbed three months later.Previous literature showed that the first peak of CCAC occurs in women aged 17-37 years, while the second peak occurs in women aged 44-88 years. The former group comprised mostly DES-exposed women and the latter those without a history of DES exposure.(3,4) Significant features for the prognosis of CCAC of the uterine cervix are related to the stage at diagnosis, tumour size, grade of nuclear atypia, pelvic lymph node status and lymphatic invasion. (3,5) The key modality of treatment for early-stage cervical carcinoma is radical abdominal hysterectomy with pelvic lymphadenectomy, which results in permanent infertility in the patient. When CCAC of the uterine cervix occurs in adolescents and women of reproductive age, other surgical options should be considered if the patient desires to maintain her fertility after treatment. We suggest that an awareness of rare, forgotten cancers (e.g. CCAC of the uterine cervix in adolescents) and the need for prompt referral to a tertiary gynaecological oncology centre should be raised among general practitioners, gynaecologists and surgeons. Additionally, CCAC of the uterine cervix in adolescents should be considered as a possible differential diagnosis of bloodstained vaginal discharge without a history of sexual abuse or DES exposure. In the interim, specialists and physicians should remain cautious and attempt to act early, assertively and properly to diagnose and treat CCAC of the uterine cervix in adolesc...

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Clear-cell adenocarcinoma of the uterine cervix in a 17-year-old adolescent

Cited by 17 publications

References 12 publications

ThinPrep Pap test of endocervical adenocarcinoma with lymph node metastasis: Report of a case in a 17‐year‐old woman

ThinPrep Pap test of endocervical adenocarcinoma with lymph node metastasis: Report of a case in a 17‐year‐old woman

Clear cell adenocarcinoma of the uterine cervix in a young pregnant woman: a case report with immunohistochemical study

Clear cell adenocarcinoma of the cervix in a ten-year-old girl without prenatal diethylstilbestrol exposure

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