Clinicopathological characteristics of patients with mucinous adenocarcinoma of the uterine cervix: A retrospective study of 21 cases

J Gynecol Obstet Hum Reprod. 2019 May;48(5):319-327. doi: 10.1016/j.jogoh.2019.02.002. Epub 2019 Feb 23.

Abstract

Objectives: Few studies in the literature take into account the WHO's 2014 redefinition of the characteristics of mucinous adenocarcinoma of the uterine cervix. Our objective was to describe the characteristics of a group of these patients.

Material and methods: This was a retrospective descriptive study of patients diagnosed between 1 January 2005 and 31 May 2016 in three hospitals in Lyon, France. All the cases of cervical adenocarcinoma were reanalysed by an expert in gynaecological pathology to retain the mucinous subtypes as defined in the 2014 WHO classification. We analysed their clinical and pathological characteristics.

Results: Among the 82 cases of cervical adenocarcinoma, 21 (26%) were diagnosed as mucinous. Ten were gastric type, of which four were in the extremely well differentiated form of minimal deviation adenocarcinomas, six were intestinal type, two were signet-ring cell type, and three were not otherwise specified. The patients' mean age was 42 years and 18 patients were premenopausal. The revealing symptom was metrorrhagia in eight cases (38%) and mucinous vaginal discharge in four (19%). Fifteen (72%) of the cervical smear were abnormal. Five (31%) of the 16 patients with gastric or intestinal type adenocarcinoma had a specific radiological presentation: multiple cysts of the uterine isthmus, visible on ultrasound and with T2 hyperintensity on MRI.

Conclusion: Mucinous adenocarcinoma is a rare form of cervical cancer that can be confused with other pathological types. It can be detected using cervical smears and should be suspected in cases of mucinous discharge and characteristic MRI features.

Keywords: Gastric type; Intestinal type; Malignant adenoma; Mucinous adenocarcinoma; Signet-ring cells; Uterine cervix.

MeSH terms

  • Adenocarcinoma, Mucinous / diagnostic imaging
  • Adenocarcinoma, Mucinous / mortality
  • Adenocarcinoma, Mucinous / pathology*
  • Adenocarcinoma, Mucinous / therapy
  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use
  • Cervix Mucus
  • Colposcopy
  • Dyspareunia / etiology
  • Female
  • France / epidemiology
  • Humans
  • Lymph Node Excision
  • Magnetic Resonance Imaging
  • Metrorrhagia / etiology
  • Middle Aged
  • Pelvic Pain / etiology
  • Retrospective Studies
  • Ultrasonography
  • Uterine Cervical Neoplasms / diagnostic imaging
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / therapy
  • Vaginal Smears

Substances

  • Antineoplastic Agents