A case of uterine cervical adenoid cystic carcinoma in a young woman diagnosed with cervical conization for an abnormal cytology result

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  • BAN Kenji
    Department of Obstetrics and Gynecology, National Hospital Organization Osaka National Hospital
  • MATSUMOTO Hisanori
    Department of Obstetrics and Gynecology, National Hospital Organization Osaka National Hospital
  • OGURA Eri
    Department of Obstetrics and Gynecology, National Hospital Organization Osaka National Hospital
  • FUJIKAMI Yusuke
    Department of Obstetrics and Gynecology, National Hospital Organization Osaka National Hospital
  • AKAGI Kana
    Department of Obstetrics and Gynecology, National Hospital Organization Osaka National Hospital
  • OKAGAKI Atsuhiko
    Department of Obstetrics and Gynecology, National Hospital Organization Osaka National Hospital
  • MORI Kiyoshi
    Department of Central Laboratory and Surgical Pathology, National Hospital Organization Osaka National Hospital
  • TATSUMI Keiji
    Department of Obstetrics and Gynecology, National Hospital Organization Osaka National Hospital

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Other Title
  • 子宮頸部細胞診異常を契機に子宮頸部円錐切除術を行い診断に至った若年子宮頸部腺様囊胞癌の1例
  • シキュウ ケイブ サイボウシン イジョウ オ ケイキ ニ シキュウ ケイブ エンスイ セツジョジュツ オ オコナイ シンダン ニ イタッタ ジャクネン シキュウ ケイブ センヨウ ノウホウ ガン ノ 1レイ

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Abstract

<p>Adenoid cystic carcinoma (ACC) is a rare tumor that is usually found in salivary glands. Uterine cervical ACC is extremely rare. We report the case of cervical ACC in a 35-year-old woman. Although cytological results indicated adenocarcinoma in situ (AIS), further examination did not reveal any abnormal findings. Histopathologically, diagnostic cervical conization revealed AIS, atypical cervical glands showing a focal cribriform appearance, small solid nests with numerous mitotic cells spreading invasively in the deep layer, and glandular structures containing eosinophilic material in the nests. The tumor cells were diffusely positive for p16, and p63-positive cells outlined the nests. The patient was therefore diagnosed with cervical ACC StageIB1, and a radical hysterectomy with bilateral adnexectomy and para-aortic lymphadenectomy were performed. The patient was given six courses of adjuvant chemotherapy with paclitaxel, carboplatin, and bevacizumab. No recurrence was observed at 48 months after surgery. The rate of ACC among all cervical cancers in Japan is 0.037%. Diagnostic cervical conization should be considered when abnormal cytology is detected in glandular cells, even though abnormal symptoms or colposcopic lesions are not detected, because cervical ACC is often complicated with malignancy of other histologic types. [Adv Obstet Gynecol, 74(1) : 86-93, 2022 (R4.2)]</p>

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