Combined signet ring cell and glassy cell carcinoma of the uterine cervix arising in a young Japanese woman: A case report with immunohistochemical and histochemical analyses

Department of Pathology, Nagoya National Hospital, Nagoya, Japan.
Pathology International (Impact Factor: 1.69). 11/2004; 54(10):787-92. DOI: 10.1111/j.1440-1827.2004.01756.x
Source: PubMed


Signet ring cell carcinoma and glassy cell carcinoma are both rare histological subtypes of uterine cervical cancer. This report is of a case of uterine cervical carcinoma arising in a 29-year-old woman who had major components of signet ring cell carcinoma and glassy cell carcinoma within the same tumor. Histochemical and immunohistochemical analyses, including high and low molecular weight cytokeratins, p63 and MUC5AC, additionally demonstrated the squamous and adenocarcinomatous differentiation in the neoplastic cells, which showed otherwise unclassifiable morphology on the haematoxylin-eosin sections. A wide range of differentiation described above supports the speculation that glassy cell carcinoma may arise from the multipotential immature cells that can differentiate into both squamous and glandular cells. It would be precise to classify this tumor as adenosquamous carcinoma. Although adenosquamous carcinoma is not a rare histological subtype in the uterine cervix, it should be necessary to report the presence of glassy cells and signet ring cells when present because the presence of both components is associated with an unfavorable clinical behavior.

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    • "Oestrogen and Progesterone receptors have been tested in only 4 previous cases [15-17,19,21] and these were present only in one example [16]. "
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    ABSTRACT: As a rule, endocervical tumours with signet-ring cell are classed as metastatic extra-genital neoplasms. In a patient aged 45 years, we describe primary cervical signet-ring cell carcinoma (PCSRCC) characterized by prominent endometrial and myometrial involvement, simulating primary endometrial adenocarcinoma with cervical extension. In addition, a review was made of the literature to identify the clinical and pathological features of this rare malignancy. A 45-year-old woman was referred to our Gynaecology Department due to persistent abnormal vaginal bleeding. Transvaginal ultrasonography showed slight endometrial irregularities in the whole uterine cavity suggestive of endometrial neoplasms. Pelvic magnetic resonance imaging revealed diffuse enlargement of the cervix, which had been replaced by a mass. Induration extended to the parametria and sigmoid colon fat.Histological examination of endometrial curettage and a cervical biopsy revealed a neoplasm characterized by neoplastic signet-ring cells and trabecular structures. Immunohistochemical analysis and molecular studies showed certain findings consistent with a cervical neoplasm, such as positivity to CEA, keratin 7, Ca-125 and p16 and the presence of HPV (Human Papilloma Virus) DNA 18.On examination of the hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy, the lesion replacing the cervix, endometrium and myometrium, revealed the same immunohistochemical findings observed on endometrial curettage and cervical biopsy specimens. Metastases were found in an ovarian cystic lesion and the lymph nodes. With this report the authors have demonstrated that the spread of cervical adenocarcinoma to the uterine corpus, although rare, may be observed, and that in this instance immunohistochemical and molecular studies can provide sufficient information for accurate diagnosis even on small biopsy specimens.
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    ABSTRACT: Resumen La mayoría de las neoplasias malignas gástricas corres- ponden histológicamente a adenocarcinomas de tipo difuso o intestinal, siendo otras variedades mucho me- nos frecuentes. Reportamos un caso de tumor epitelial maligno, cuyas características histológicas y citológicas corresponden a una entidad inusual aunque bien defi- nida que puede aparecer en el cérvix y menos frecuen- temente en el endometrio, conocido como adenocarci- noma de la variante glassy - cell. No hemos encontra- do ningún reporte previo de este particular tipo de tu- mor en localización gástrica. Se discuten la histogéne- sis y los diagnósticos diferenciales. Summary "Glassy - Cell" like adenocarcinoma: A new variant of gastric tumor Most gastric malignancies correspond histologically to adenocarcinomas, either of the intestinal or diffuse ty- pe, other tumoral varieties being much less frequent. We report a case of a malignant epithelial tumor, who- se histological and cytological characteristics correspond to an unusual, although well defined entity, which may appear in the cervix and less frequently in the en- dometrium, known as adenocarcinoma of the glassy - cell variety. We have not found any previous reports of this particular .
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    ABSTRACT: Objective To present the case report of a patient with undifferentiated and diffuse signet-ring cell gastric carcinoma in which FDG-PET evidenced recurrent disease.Materials and methodsThe patient was diagnosed of a stage III gastric carcinoma in 1994 and was treated with a subtotal gastrectomy. In February 2003, recurrent disease was detected in mediastinal and left supraclavicular lymph nodes. The patient was treated with chemotherapy and radiotherapy, reaching a complete response. After 6 months free of disease, he presented an elevation of the tumor markers with negative results in conventional imaging methods (upper digestive endoscopy, bone scintigraphy, and CT). An FDG-PET scan was performed to rule out recurrent disease.ResultsFDG-PET detected pathologic findings suggestive of malignant disease in right supraclavicular and mediastinal lymph nodes. These findings were confirmed by clinical follow-up and with another CT scan performed 4 months later.Conclusions In this case report we stress the importance of early recurrence by FDG-PET in a non-intestinal gastric carcinoma. This is of interest given the greater difficulty to detect mucous secreting and/or producing carcinomas with the PET-FDG.
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