Endometrioid adenocarcinoma arising from adenomyosis: Report and immunohistochemical analysis of an unusual case

Abstract

A case of endometrioid adenocarcinoma arising from adenomyosis is reported. The patient was a 53-year-old woman who complained of vulvar itching. Smear cytology of the endometrium revealed adenocarcinoma. Magnetic resonance imaging of the pelvis revealed a lesion with a slightly high intensity in the uterine fundus on a T2-weighted image. Semiradical total hysterectomy and bilateral adnexectomy were performed, followed by chemotherapy. Histologically, the lesion in the uterine fundus was composed mostly of adenocarcinoma with stromal invasion. There were many adenomyotic foci in and around the carcinoma, including some showing transition to adenocarcinoma. There was no malignant finding in the normally situated endometrium. The carcinoma invaded in the myometrium, involving the uterine serosa, but no dissemination to the peritoneal cavity was found. The carcinoma was, therefore, considered to be endometrioid adenocarcinoma arising from adenomyosis. Immunohistochemistry showed expression of p53 oncoprotein and Ki-67 antigen in the carcinoma cells. The value of immunohistochemistry in predicting prognosis is discussed.

Clear Cell Adenocarcinoma Arising From Adenomyosis

“…They reviewed 4 cases of their own patients and 26 previously reported cases of patients in 2002 with malignant neoplasm arising from adenomyosis (2). We found 9 additional cases of patients with malignant neoplasms arising from adenomyosis in English literature (3)(4)(5)(6)(7)(8)(9)(10)(11). Most of the malignant tumors arising The diagnostic criteria for ovarian carcinoma arising from endometriosis were originally proposed by Sampson (12) and modified by Colman and Rosenthal (13) so as to apply the criteria to carcinomas developing from adenomyosis as follows: a) the carcinoma should be absent in the normally situated endometrium and elsewhere in the pelvis; b) the carcinoma should be actually observed to be arising from the epithelium of the areas of adenomyosis and not invading it from some other source; and c) endometrial stromal cells should be surrounding the aberrant glands to support the diagnosis of adenomyosis.…”

Adenomyosis and Endometrial Cancer: Literature Review

“…A case with positive preoperative endometrial cytology containing many atypical papillary clusters with features of adenocarcinoma was reported by Sasaki et al [45] who maintained that the origin of the cells was uncertain. Also, Kawana et al [75] described a case where three-dimensional clusters of malignant cells were found in endometrial cytology.…”

The Risks for Ovarian, Endometrial, Breast, Colorectal, and Other Cancers in Women With Newly Diagnosed Endometriosis or Adenomyosis: A Population-Based Study

“…Thus, the condition is also known as ''internal'' endometriosis. 16 Whether internal adenomyosis is also associated with an increased risk of certain malignancies remains unclear. Currently, there are a paucity of data on the association between adenomyosis and cancer risk.…”

“…Currently, there are a paucity of data on the association between adenomyosis and cancer risk. 16,17 Therefore, we examined the risk of cancer, particularly ovarian, endometrial, mammary, and CRC, in women with endometriosis or adenomyosis using a well-established nationwide population-based administrative database.…”