Synchronous mucinous adenocarcinoma of the endometrium and mucinous cystadenoma of bilateral ovaries presenting during fertility therapy

Abstract

We describe a very rare case of synchronous mucinous tumor of the endometrium and ovaries presenting during ovulation induction. A 31-year-old woman received ovulation induction for 5-year primary infertility. Ultrasonography revealed mucus retention in the uterine cavity and bilateral multicystic ovaries during ovulation induction. Atypical hyperplasia was diagnosed by endometrial curettage. Repeated procedures including ovarian cystectomy, endometrial curettage and in vitro fertilization combined with progestine therapy resulted in no pregnancy but rapid recurrences. She finally underwent simple hysterectomy and bilateral salpingo-oophorectomy. Microscopic examination revealed mucinous cystadenoma in the both ovaries and well differentiated mucinous adenocarcinoma of the endometrium.

Magnetic resonance imaging findings and prognosis of gastric-type mucinous adenocarcinoma (minimal deviation adenocarcinoma or adenoma malignum) of the uterine corpus: Two case reports

“…The findings of the two previously reported cases, in addition to our case, are summarized in Table I. Gotoh et al (4) reported a case of synchronous mucinous adenocarcinoma of the endometrium and mucinous cystadenoma involving both ovaries in a 31-year-old woman with primary infertility. The three cases exhibited morphology, immunophenotype and clinical characteristics that are similar to those of gastric-type adenocarcinoma originating from the uterine cervix.…”

“…The clinical behaviors of the cancer in our two cases indicates that gastric-type mucinous adenocarcinoma of the uterine endometrium exhibits an aggressive clinical behavior, even if the morphological findings are those of low-grade adenocarcinoma. The case reported by Gotoh et al, however, exhibited concomitant atypical endometrial hyperplasia and was stage IA (4). In that case, following complete resection, the prognosis was good, as the patient was reported to remain alive and cancer-free.…”

“…This type of adenocarcinoma of the uterine cervix is considered to be associated with poor prognosis due to its more aggressive clinical behavior compared with the usual types of adenocarcinoma of the uterine cervix (6,8). However, among mucinous adenocarcinomas of the uterine corpus, only two cases displaying the gastric phenotype have been previously reported in the English literature (3,4). Therefore, the biological characteristics of this type of tumor have not been fully elucidated, owing to its rarity.…”

“…Abiko et al, from our institution, documented the first case of mucinous endometrial adenocarcinoma with gastric-type histology (3). This histological subtype, however, is a rare malignant disease with only two case reports in the literature (3,4). Thus, the clinical behavior of this rare disease has not been fully elucidated.…”

Recurrent mucinous cystadenoma in a 20‐year‐old woman: Was hysterectomy inevitable?

“…Another case with recurrent bilateral ovarian mucinous cystadenoma was described in a 31‐year‐old woman receiving ovulation induction for 5‐year primary infertility. After repeated cystectomies, she finally underwent simple hysterectomy and bilateral salpingo‐oophorectomy 3 . Our present case is the youngest to undergo hysterectomy, at the age of 21 years.…”