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CASE REPORT
Endocervical gastric-type adenocarcinoma, an unrelated HPV tumour: difficulties in screening and diagnosis
  1. Priscila Carneiro Lima1,
  2. Julio Teixeira1⇑,
  3. Guilherme Nogueira Aires1,
  4. Liliana De Angelo Andrade2
  1. 1 Tocoginecology, Universidade Estadual de Campinas Faculdade de Ciencias Medicas, Campinas, Brazil
  2. 2 Pathology, Universidade Estadual de Campinas Faculdade de Ciencias Medicas, Campinas, Brazil
  1. Correspondence to Dr Julio Teixeira, juliotex{at}uol.com.br

Summary

Gastric-type adenocarcinoma of the cervix (GAS) is an uncommon and aggressive tumour unrelated to human papillomavirus (HPV) infection with distinctive histological and immunohistochemical characteristics. GAS may be associated with lobular endocervical glandular hyperplasia (LEGH), another unusual lesion. We report a case of a 59-year-old woman with screening cytology 'AGC-Neo' and cervical conisation exhibiting cervical intraepithelial neoplasia grade 1, extensive LEGH and canal sampling with abundant mucinous cells. Based on the possible association between LEGH and GAS, a total hysterectomy was performed. The histological diagnosis revealed a morphological gradient of lesions: LEGH, minimal deviation adenocarcinoma and GAS with lymphatic invasion. Immunohistochemistry revealed strong MUC6 expression and no p16 staining. After pelvic radiotherapy, the patient continues follow-up evaluation. The diagnostic difficulties of GAS and its relationship with LEGH are discussed. This rare tumour is important because it is poorly symptomatic and potentially aggressive. In addition, the methods for cancer control related to HPV do not affect this tumour.

  • Cancer - see Oncology
  • Cervical cancer
  • Cervical screening

https://doi.org/10.1136/bcr-2017-219724

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    Footnotes

    • Contributors PCL: identified the case, planning, acquisition and interpretation of data, literature review, wrote the manuscript's draft and final version.

      JT: identified the case, planning, acquisition and interpretation of data, wrote the manuscript's final version.

      GNA: managed the case, planning, acquisition and interpretation of data, reviewed the manuscript's final version.

      LdAA: identified the case, planning, acquisition and interpretation of data, literature review, wrote the manuscript's draft and final version.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.