Gastric-type cervical adenocarcinoma with squamous differentiation: buried in adenosquamous carcinomas?

Yoshida, Hiroshi; Naka, Tomoaki; Kobayashi-Kato, Mayumi; Kikkawa, Nao; Tanase, Yasuhito; Uno, Masaya; Ishikawa, Masatoshi; Kato, Tomoyasu

doi:10.1007/s00428-020-02997-0

Cited by 4 publications

(4 citation statements)

References 15 publications

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“…The squamous cell carcinoma element was the minor component in both cases (5% and 20%); similarly in our case, the squamous areas comprised around 30% of the tumor. In one case reported by Yoshida et al 14 , there was adjacent atypical lobular endocervical glandular hyperplasia and in the other, there was gastric-type adenocarcinoma in situ 19 . Both cases were advanced stage at diagnosis with large bulky tumors, parametrial invasion and nodal metastasis.…”

Section: Discussionmentioning

confidence: 86%

“…This represents the third report of a cervical HPV-independent gastric-type adenosquamous carcinoma. Yoshida et al 14 recently reported the first 2 cases of gastric-type adenosquamous carcinoma of the cervix. Both tumors were HPV negative (no block-type staining with p16 and negative in situ hybridization for HPV).…”

Section: Discussionmentioning

confidence: 99%

“…In Western countries, HPV-independent adenocarcinomas account for ~10% of cervical adenocarcinomas with gastric-type making up approximately two-thirds of these neoplasms (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13), meaning that gastric-type adenocarcinoma comprises ~7% of cervical adenocarcinomas. There has been a single report of 2 cases of cervical gastric-type adenocarcinoma exhibiting malignant squamous differentiation (gastric-type adenosquamous carcinoma) (14) but this phenomenon is not well known to pathologists and adenosquamous carcinomas are often assumed to be invariably HPV-associated neoplasms. In this report, we describe a case of a cervical gastric-type adenosquamous carcinoma which on molecular testing contained pathogenic variants (PVs) in BRCA1 and KRAS.…”

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confidence: 99%

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Cervical Gastric-type Adenosquamous Carcinoma: Case Report of a Rare Neoplasm Associated With a BRCA1 Pathogenic Variant

Rajendran

McGivern

González

et al. 2023

International Journal of Gynecological Pathology

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Gastric-type adenocarcinoma is the commonest human papillomavirus (HPV)-independent adenocarcinoma of the cervix. We report a rare case of a primary cervical gastric-type adenocarcinoma with malignant squamous elements (gastric-type adenosquamous carcinoma) in a 64-yr-old female. This is only the third report of a cervical gastric-type adenosquamous carcinoma. The tumor was p16 negative and molecular studies for HPV were negative. Next-generation sequencing showed pathogenic variants in BRCA1 and KRAS, as well as variants of unknown significance in CDK12 and ATM and homozygous deletion of CDKN2A/CDKN2B. Pathologists should be aware that not all cervical adenosquamous carcinomas are HPV-associated and the term gastric-type adenosquamous carcinoma is recommended when malignant squamous elements are present within a gastric-type adenocarcinoma. In reporting this case, we discuss the differential and the possible therapeutic options raised by the presence of pathogenic variants in BRCA1.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Cervical Gastric-type Adenosquamous Carcinoma: Case Report of a Rare Neoplasm Associated With a BRCA1 Pathogenic Variant

Rajendran

McGivern

González

et al. 2023

International Journal of Gynecological Pathology

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“…Although no recurrent gene alterations were identified in the three HPV-negative ASC cases, true HPV-independent ASCs may exist as a result of squamous differentiation in HPV-independent cancers, such as squamous differentiation in endometrioid carcinoma derived from cervical endometriosis. Recently, we reported two GAS cases with squamous differentiation and HPV-negative ASC formation [ 128 ]. Both had an advanced stage (pT2bN1) with predominant GAS and merged SqCC components without p16-block positivity or HPV DNA.…”

Section: Pathology and Genetics Of Hpv-independent Cervical Cancermentioning

confidence: 99%

Molecular Pathology of Human Papilloma Virus-Negative Cervical Cancers

Yoshida

Shiraishi

Kato³

2021

Cancers

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Cervical cancer is the fourth most common cancer in women worldwide and is predominantly caused by infection with human papillomavirus (HPV). However, a small subset of cervical cancers tests negative for HPV, including true HPV-independent cancers and false-negative cases. True HPV-negative cancers appear to be more prevalent in certain pathological adenocarcinoma subtypes, such as gastric- and clear-cell-type adenocarcinomas. Moreover, HPV-negative cervical cancers have proven to be a biologically distinct tumor subset that follows a different pathogenetic pathway to HPV-associated cervical cancers. HPV-negative cervical cancers are often diagnosed at an advanced stage with a poor prognosis and are expected to persist in the post-HPV vaccination era; therefore, it is important to understand HPV-negative cancers. In this review, we provide a concise overview of the molecular pathology of HPV-negative cervical cancers, with a focus on their definitions, the potential causes of false-negative HPV tests, and the histology, genetic profiles, and pathogenesis of HPV-negative cancers.

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Gastric Type Endocervical Adenocarcinoma With Concurrent High-Grade Squamous Intraepithelial Lesion: A Clinicopathologic Study of Three Patients

Sun,

Lin,

Zou

et al. 2024

Int J Surg Pathol

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Objective We investigate gastric-type endocervical adenocarcinoma (ECA), a prominent HPV-independent adenocarcinoma, and its coexistence with high-grade squamous intraepithelial lesion (HSIL) through the examination of three such tumors. Methods In this study, we conducted an in-depth review of three patients with gastric-type ECA, each associated with high-risk HPV infection as detected on Pap smears. We detailed the clinical and pathological features of each patient and utilized RNAscope for high-risk HPV testing to ascertain HPV status in both gastric-type ECA and HSIL components. Immunohistochemistry with p16, p53, and other biomarkers was also applied. Results The gastric-type ECA component, characterized by well-differentiated glands with abundant, clear to eosinophilic cytoplasm, distinct cellular borders, and pale nuclei with conspicuous nucleoli, tested negative for both p16 and high-risk HPV, unlike the concurrent HSIL components which were positive. Additionally, two tumors showed aberrant p53 protein expression in the gastric-type ECA areas, and elevated carbohydrate antigen19-9 levels were noted in two patients. Treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy, supplemented by chemotherapy and/or radiation, with disease-free intervals of 24, 12, and 40 months post-treatment, respectively. Conclusion This study highlights the critical need for meticulous diagnostic protocols that combine morphological examination, immunohistochemistry, and HPV RNA in situ hybridization. The rarity of gastric-type ECA coexisting with HPV infection underscores the necessity for continuous research and vigilant monitoring in the field of gynecological oncology.

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Gastric-type cervical adenocarcinoma with squamous differentiation: buried in adenosquamous carcinomas?

Cited by 4 publications

References 15 publications

Cervical Gastric-type Adenosquamous Carcinoma: Case Report of a Rare Neoplasm Associated With a BRCA1 Pathogenic Variant

Cervical Gastric-type Adenosquamous Carcinoma: Case Report of a Rare Neoplasm Associated With a BRCA1 Pathogenic Variant

Molecular Pathology of Human Papilloma Virus-Negative Cervical Cancers

Gastric Type Endocervical Adenocarcinoma With Concurrent High-Grade Squamous Intraepithelial Lesion: A Clinicopathologic Study of Three Patients

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