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Zeer ZMM, Jawaada D, Bannoura S, Jaber S. Unusual spread of cervical adenocarcinoma to the endometrium and left fallopian tube: a case report and literature review. Ann Med Surg (Lond) 2024; 86:4181-4186. [PMID: 38989238 PMCID: PMC11230810 DOI: 10.1097/ms9.0000000000002153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/30/2024] [Indexed: 07/12/2024] Open
Abstract
Introduction The incidence of cervical adenocarcinoma and adenocarcinoma in situ are gradually increasing especially in younger women. However, unusual spread of cervical adenocarcinoma has rarely been reported. Case presentation The authors report a case of a 60-year-old woman who presented with postmenopausal bleeding. She was misdiagnosed to have endometrial adenocarcinoma on the lower uterine segment depending on curettage specimen. After hysterectomy, it was revealed depending on morphological features in histology accompanied with immunohistochemistry that the patient had cervical adenocarcinoma with endometrial and left fallopian tube extension. Discussion Distinguishing endocervical adenocarcinoma from endometroid adenocarcinoma poses many challenges especially when evaluating endometrial curettage specimens. Histological diagnosis based on morphological features combined with a panel of immunohistochemistry stains is crucial for accurate diagnosis and identifying the primary origin of the tumor. Conclusion Accurate distinction between cervical adenocarcinoma versus endometrial adenocarcinoma is important because of its significant effects on choosing the appropriate treatment option.
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Affiliation(s)
| | | | - Sami Bannoura
- Department of Pathology, Al-Makassed Hospital, Jerusalem, Palestine
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2
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Xiao ML, Fu L, Ma FH, Li YA, Zhang GF, Qiang JW. Comparison of MRI features among squamous cell carcinoma, adenocarcinoma and adenosquamous carcinoma, usual-type endocervical adenocarcinoma and gastric adenocarcinoma of cervix. Magn Reson Imaging 2024; 112:10-17. [PMID: 38848968 DOI: 10.1016/j.mri.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/21/2024] [Accepted: 06/04/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVE To compare and explore the characteristics of squamous cell carcinoma (SCC), adenocarcinoma (AC) and adenosquamous carcinoma (ASC), usual-type endocervical adenocarcinoma (UEA) and gastric adenocarcinoma (GAC) of cervix. MATERIALS AND METHODS A total of 728 cervical cancers (254 cases of AC, 252 cases of ASC, and 222 cases of SCC) confirmed by histopathology were retrospectively reviewed. Among AC, 119 UEA and 47 GAC were included. Clinical baseline data and tumor morphological features on MRI (including tumor location, shape, diameter and volume, margin, growth pattern, presence of fluid component or cyst, heterogenous and peritumoral enhancement) of all cases were collected and analyzed. The signal intensity (SI) of tumor and gluteus maximus muscle were measured and their ratios (SIR) were calculated based on T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and contrast-enhanced T1WI at arterial and delay phases (A/DCE-T1WI). These clinical and MRI features were compared between SCC, AC and ASC, UEA and GAC, and the specific ones of each subtype were identified. RESULTS There was a significant difference in SCC-Ag, CA-199, CEA, ADC value, SIR-DWI, presence of intratumor cyst and peritumoral enhancement between AC and ASC; in patient age, menopausal status, International Federation of Gynecology and Obstetrics (FIGO) stage, SCC-Ag, CA-125, CA-199, CEA, tumor shape, growth pattern, margin, presence of intratumor fluid component and cyst, tumor diameter and volume, ADC value, SIR-T1WI, SIR-T2WI, and SIR-DWI between SCC and AC, as well as SCC and ASC. Also, there was a significant difference in deep stromal invasion (DSI), peritumoral and heterogenous enhancement between SCC and AC, and in SIR-ACE-T1WI between SCC and ASC. There was a significant difference in reproductive history, menopausal status, FIGO stage, CA-199, DSI, lymph node metastasis (LNM), parametrial invasion (PMI), tumor location, shape, margin, growth pattern, presence of fluid component and cyst, tumor diameter and volume, SIR-T1WI, SIR-DWI, and heterogenous enhancement between GAC and UEA. CONCLUSION The clinical and MRI features with significant differences among SCC, AC and ASC, and between UEA and GAC, can help to identify each subtype of cervical cancer.
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Affiliation(s)
- Mei Ling Xiao
- Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai 201508, China; Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou 310009, China
| | - Le Fu
- Department of radiology, Shanghai First Maternity and Infant Hospital, Tongji University, 536 ChangleRoad, Shanghai 200092, China
| | - Feng Hua Ma
- Departments of Radiology, Obstetrics & Gynecology Hospital, Fudan University, 128 Shenyang Road, Shanghai 200090, China
| | - Yong Ai Li
- Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai 201508, China
| | - Guo Fu Zhang
- Departments of Radiology, Obstetrics & Gynecology Hospital, Fudan University, 128 Shenyang Road, Shanghai 200090, China
| | - Jin Wei Qiang
- Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai 201508, China.
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Liu J, Li S, Zhang Y, Cheng J. Gastric-type adenocarcinoma of the uterine cervix: A case report. Asian J Surg 2024; 47:2952-2953. [PMID: 38418324 DOI: 10.1016/j.asjsur.2024.02.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 02/16/2024] [Indexed: 03/01/2024] Open
Affiliation(s)
- Jie Liu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Shujian Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Liu S, Li F, Cao Q, Li N, Gao Q. A Case Study of Gastric Adenocarcinoma and Squamous Cell Carcinoma of the Cervix. Onco Targets Ther 2024; 17:339-344. [PMID: 38644954 PMCID: PMC11027916 DOI: 10.2147/ott.s435811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/28/2024] [Indexed: 04/23/2024] Open
Abstract
Gastric adenocarcinoma (GAS) is a rare subtype of mucinous adenocarcinoma characterized by gastric differentiation and is unrelated to human papillomavirus (HPV) infection. This report discusses a 40-year-old female who presented with abdominal distension accompanied by increased abdominal circumference. CT of the abdomen and pelvis showed a large 21.0*12.7*26.0 cm mass later diagnosed as GAS combined with squamous cell carcinoma on surgical pathology. Immunohistological staining of GAS was positive for CK7, MUC6, PAX-8 CEA, and P53 (wild type) and negative for CDX2, CK20, ER, PR, P16, and WT1. The proliferative index (Ki-67) was 20%. Immunohistochemical staining of squamous cell carcinoma was positive for P16 and P53 (wild type), and the proliferative index (Ki-67) was 90%. However, the pathogenesis and molecular mechanisms of GAS have not been fully elucidated. As more cases are identified and reported, additional targeted therapies can be developed and tested in these patients.
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Affiliation(s)
- Suqing Liu
- Department of Gynaecology and Obstetrics, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, People’s Republic of China
| | - Fengling Li
- Department of Gynaecology and Obstetrics, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, People’s Republic of China
| | - Qinghua Cao
- Department of Pathology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, People’s Republic of China
| | - Ning Li
- Department of Gynaecology and Obstetrics, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, People’s Republic of China
| | - Qian Gao
- Department of Gynaecology and Obstetrics, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, People’s Republic of China
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Agapie ML, Borjog FT, Dumitraşcu CO, Prăjescu R, Popescu M, Orban C. Autoimmune encephalitis and paraneoplastic encephalitis: difficulties in diagnosis and management in the ICU. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2023; 64:475-482. [PMID: 38184827 PMCID: PMC10863685 DOI: 10.47162/rjme.64.4.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/15/2023] [Indexed: 01/09/2024]
Abstract
Autoimmune encephalitis (AIE) represents a category of relatively newly described neurological disorders associated with an increasing prevalence, a significant impact on the healthcare system, and a high rate of intensive care unit (ICU) admission. This category of diseases often requires prompt treatment, even before a definitive diagnosis is established. In the ICU, patients present with nonspecific signs and symptoms for AIE, which pose challenges in both management and diagnosis. Patients frequently exhibit dysautonomia, severe physical and psychic agitation, as well as tremors and dyskinesia, all of which complicate the diagnosis. They are prone to developing infections, including ventilator-associated pneumonia, and issues related to difficult venous access and pressure ulcers. Early initiation of immunosuppressive treatment is necessary to improve patients' outcome. Through this article, we aimed to summarize current knowledge in terms of the difficulties in diagnosing and management of this pathology in the ICU, as well as the implications for the healthcare system in terms of human and financial resources.
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Affiliation(s)
- Mihaela Livia Agapie
- Department of Anesthesiology and Intensive Care, Emergency University Hospital Bucharest, Romania;
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Lee J, Shin S, Kim JH, Lee SL, Chong Y, Seo KJ, Yim K. Uterine Cervical Angioleiomyoma Mimicking Squamous Cell Carcinoma. Diagnostics (Basel) 2023; 13:2370. [PMID: 37510114 PMCID: PMC10378435 DOI: 10.3390/diagnostics13142370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/01/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Angioleiomyoma, a rare variant of leiomyoma, is a benign tumor of mesenchymal origin. Angioleiomyomas of the female urogenital tract are extremely rare, with only six cases of uterine cervical angioleiomyoma previously reported in the literature. In this case study, we report on a 49-year-old female patient who presented with menorrhagia whose initial magnetic resonance imaging (MRI) findings suggested cervical squamous cell carcinoma (SCC). However, following the hysterectomy, histological examination confirmed the lesion to be angioleiomyoma. To the best of our knowledge, there have been no previously reported cases of angioleiomyomas presenting with MRI findings that are suggestive of uterine SCC. Recognizing that angioleiomyomas can mimic uterine malignancies on MRI may prove beneficial for future diagnostic and treatment strategies.
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Affiliation(s)
- Jiwon Lee
- College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Seoyeon Shin
- College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jin-Hwi Kim
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Su Lim Lee
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Yosep Chong
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Kyung Jin Seo
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Kwangil Yim
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Li S, Liu J, Guo R, Nickel MD, Zhang Y, Cheng J, Zhu J. T 1 mapping and extracellular volume fraction measurement to evaluate the poor-prognosis factors in patients with cervical squamous cell carcinoma. NMR IN BIOMEDICINE 2023:e4918. [PMID: 36914267 DOI: 10.1002/nbm.4918] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE To evaluate the clinical feasibility of T1 mapping and extracellular volume fraction (ECV) measurement in assessing prognostic factors in patients with cervical squamous cell carcinoma (CSCC). MATERIALS AND METHODS A total of 117 CSCC patients and 59 healthy volunteers underwent T1 mapping and diffusion-weighted imaging (DWI) on a 3 T system. Native T1 , contrast-enhanced T1 , ECV, and apparent diffusion coefficient (ADC) were calculated and compared based on surgico-pathologically verified deep stromal infiltration, parametrial invasion (PMI), lymphovascular space invasion (LVSI), lymph node metastasis, stage, histologic grade, and the Ki-67 labeling index (LI). RESULTS Native T1 , contrast-enhanced T1 , ECV, and ADC values were significantly different between CSCC and the normal cervix (all p < 0.05). No significant differences were observed in any parameters of CSCC when the tumors were grouped by stromal infiltration or lymph node status, respectively (all p > 0.05). In subgroups of the tumor stage and PMI, native T1 was significantly higher for advanced-stage (p = 0.032) and PMI-positive CSCC (p = 0.001). In subgroups of the grade and Ki-67 LI, contrast-enhanced T1 was significantly higher for high-grade (p = 0.012) and Ki-67 LI ≥ 50% tumors (p = 0.027). ECV was significantly higher in LVSI-positive CSCC than in LVSI-negative CSCC (p < 0.001). ADC values showed a significant difference for the grade (p < 0.001) but none for the other subgroups. CONCLUSION Both T1 mapping and DWI could stratify the CSCC histologic grade. In addition, T1 mapping and ECV measurement might provide more quantitative metrics for noninvasively predicting poor prognostic factors and aiding in preoperative risk assessment in CSCC patients.
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Affiliation(s)
- Shujian Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jie Liu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rufei Guo
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthcare Ltd., Beijing, China
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8
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Mori T, Kato H, Kawaguchi M, Kanayama T, Furui T, Noda Y, Hyodo F, Matsuo M. MRI characteristics for predicting histological subtypes in patients with uterine cervical adenocarcinoma. Eur J Radiol 2023; 158:110612. [PMID: 36542931 DOI: 10.1016/j.ejrad.2022.110612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 10/17/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate the magnetic resonance imaging (MRI) findings of uterine cervical adenocarcinoma for predicting different histological subtypes. MATERIALS AND METHODS We retrospectively analyzed MRI findings of 76 consecutive patients with histopathologically-confirmed uterine cervical adenocarcinoma undergoing preoperative MRI examination. An experienced pathologist classified the histological subtypes based on World Health Organization's 2020 classification and into human papillomavirus (HPV)-associated adenocarcinomas (HPVAs, n = 54) (usual type and variants) and HPV-independent adenocarcinomas (HPVIs, n = 22) (gastric type adenocarcinoma (GAS), clear cell type, and other types). Different MRI variables were compared quantitatively and qualitatively between HPVA and HPVI and between GAS and non-GAS tumor types. RESULTS The maximum tumor diameter was significantly greater in HPVIs than HPVAs (41.9 ± 18.6 vs 32.7 ± 15.6 mm; p < 0.05). Heterogeneous enhancement on fat-suppressed gadolinium-enhanced T1-weighted images was more frequently seen in HPVIs than HPVAs (62 % vs 15 %; p < 0.01) and in GASs than non-GASs (78 % vs 16 %; p < 0.01). Also, infiltrative growth pattern (58 % vs 20 %; p < 0.05) and intratumoral cyst formation (83 % vs 47 %) (p < 0.05) were more frequent in GASs than non-GASs. CONCLUSIONS Compared with HPVAs, HPVIs tend to have a larger tumor size with heterogeneous enhancement, of which GASs frequently show infiltrative growth patterns with intratumoral cyst formation and heterogeneous enhancement.
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Affiliation(s)
- Takayuki Mori
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Hiroki Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Masaya Kawaguchi
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | | | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Gifu University, Gifu, Japan
| | - Yoshifumi Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Fuminori Hyodo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Institute for Advanced Study, Gifu University, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
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Jeon J, Park BK, Lee JW, Choi CH, Lee YY, Kim TJ, Kim BG. Invisible cervical cancers on MRI: Can the type of histology (SCC versus non-SCC) influence surgical planning? Front Oncol 2022; 12:996516. [PMID: 36568188 PMCID: PMC9773832 DOI: 10.3389/fonc.2022.996516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
Background Invisible cervical cancers on MRI can indicate less invasive surgery. Cervical cancers consist of squamous cell carcinoma (SCC) and non-SCC, each with different long-term outcomes. It is still unclear if surgical planning should be changed according to the histologic type of cervical cancer when it is not visible on MRI. Purpose The purpose of the study was to determine if surgical planning for cervical cancer that is not visible on MRI is influenced by the histologic type. Materials and methods Between January 2007 and December 2016, 155 women had Federation of Gynecology and Obstetrics (FIGO) stage 1B1 cervical cancer that was not visible on preoperative MRI. They underwent radical hysterectomies and pelvic lymph node dissections. Among them, 88 and 67 were histologically diagnosed with SCC and non-SCC, respectively. The size of the residual tumor, depth of stromal invasion, parametrial invasion, vaginal invasion, lymphovascular invasion, and lymph node metastasis were compared between these patients using the t-test, Mann-Whitney U test, Chi-squared test, or Fisher's exact test. The recurrence-free and overall 10-year survival rates were compared between the groups by Kaplan-Meier analysis. Results The mean sizes of residual tumors were 8.4 ± 10.4 mm in the SCC group and 12.5 ± 11.9 mm in the non-SCC group (p = 0.024). The mean depth of stromal invasion in the SCC group was 12.4 ± 21.2% (0%-100%), whereas that in the non-SCC group was 22.4 ± 24.4 (0%-93%) (p = 0.016). However, there was no difference in parametrial or vaginal invasion, lymphovascular invasion, or lymph node metastasis (p = 0.504-1.000). The recurrence-free and overall 10-year survival rates were 98.9% (87/88) and 95.5% (64/67) (p = 0.246), and 96.6% (85/88) and 95.5% (64/67) (p = 0.872), respectively. Conclusions The non-SCC group tends to have larger residual tumors and a greater depth of stromal invasion than the SCC group, even though neither is visible on MRI. Therefore, meticulous care is necessary for performing parametrectomy in patients with non-SCC cervical cancer.
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Affiliation(s)
- Jungeun Jeon
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Byung Kwan Park
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea,*Correspondence: Byung Kwan Park, ; Jeong-Won Lee,
| | - Jeong-Won Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea,*Correspondence: Byung Kwan Park, ; Jeong-Won Lee,
| | - Chel Hun Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoo-Young Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae-Joong Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Byoungi-Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Diagnosis of Early Cervical Cancer with a Multimodal Magnetic Resonance Image under the Artificial Intelligence Algorithm. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:6495309. [PMID: 35386728 PMCID: PMC8967556 DOI: 10.1155/2022/6495309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 12/03/2022]
Abstract
This research was conducted to explore the value of multimodal magnetic resonance imaging (MRI) based on the alternating direction algorithm in the diagnosis of early cervical cancer. 64 patients diagnosed with early cervical cancer clinicopathologically were included, and according to the examination methods, they were divided into A group with conventional multimodal MRI examination and B group with the multimodal MRI examination under the alternating direction algorithm. The diagnostic results of two types of multimodal MRI for early cervical cancer staging were compared with the results of clinicopathological examination to judge the application value in the early diagnosis of cervical cancer. The results showed that in the 6 randomly selected samples of early cervical cancer patients, the peak signal-to-noise ratio (PSNR) and structural similarity image measurement (SSIM) of multimodal MRI images under the alternating direction algorithm were significantly higher than those of conventional multimodal MRI images and the image reconstruction was clearer under this algorithm. By comparing MRI multimodal staging, statistical analysis showed that the staging accuracy of B group was 75%, while that of A group was only 59.38%. For the results of postoperative medical examinations, the examination consistency of B group was better than that of A group, with a statistically significant difference (P < 0.05). The area under the receiver operating characteristic (ROC) curve (AUC) of B group was larger than that of A group; thus, sensitivity was improved and misdiagnosis was reduced significantly. Multimodal MRI under the alternating direction algorithm was superior to conventional multimodal MRI examination in the diagnosis of early cervical cancer, as the lesions were displayed more clearly, which was conducive to the detection rate of small lesions and the staging accuracy. Therefore, it could be used as an ideal MRI method for the assistant diagnosis of cervical cancer staging.
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Wang Y, Shan X, Li M, Yue Y. Case Report: Giant Pelvic Cystic Appearance—An Unusual Feature of Uterine Cervical Adenocarcinoma. Front Surg 2022; 9:841255. [PMID: 35356498 PMCID: PMC8959486 DOI: 10.3389/fsurg.2022.841255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/25/2022] [Indexed: 11/17/2022] Open
Abstract
Cervical adenocarcinoma can present as a solid, mixed solid, cystic, or multiple cystic cervical mass in the endocervical canal. In this report, we present an extremely rare case of cervical adenocarcinoma with giant cystic lesions. A 37-year-old Chinese woman with a regular menstrual cycle presented to her local doctor complaining of mild abdominal distension. Abdominal ultrasonography suggested an ovarian cyst, whose mean diameter increased from 3 to 8 cm in 3 months. Thereafter, she was referred to our hospital. She had no abnormal vaginal bleeding or discharge. Transvaginal ultrasonography revealed a 95 × 80 mm cyst below the back of the uterus. Computed tomography revealed a 9.8 × 8.5 cm multilocular cyst between the cervix and right ovary. Human papillomavirus (HPV)-E6 and -E7 mRNA tests revealed HPV-16 positivity. The thin-layer, liquid-based cytological test of the cervix showed negative results. No tumor lesions were observed on the cervical biopsy histopathology. The lesion was misdiagnosed as an ovarian cyst prior to the surgery. Intraoperatively, a cyst of the size of a child's head was observed extending from the low posterior wall of the uterus to the posterior lip of the cervix, and the cervical cysts were resected. Histological examination revealed cervical adenocarcinoma. Subsequently, she underwent extensive hysterectomy, bilateral salpingectomy, and pelvic lymphadenectomy. The final diagnosis was stage IB3 cervical adenocarcinoma. After 21 months of follow-up, no clinical or radiological evidence of recurrence has been found.
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Affiliation(s)
- Yongxin Wang
- Department of Gynecologic Oncology, The First Hospital of Jilin University, Changchun, China
| | - Xue Shan
- Department of Cardiac Surgery, The First Hospital of Jilin University, Changchun, China
| | - Man Li
- Department of Gynecologic Oncology, The First Hospital of Jilin University, Changchun, China
| | - Ying Yue
- Department of Gynecologic Oncology, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Ying Yue
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12
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Magnetic Fields and Cancer: Epidemiology, Cellular Biology, and Theranostics. Int J Mol Sci 2022; 23:ijms23031339. [PMID: 35163262 PMCID: PMC8835851 DOI: 10.3390/ijms23031339] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/22/2022] [Accepted: 01/22/2022] [Indexed: 02/08/2023] Open
Abstract
Humans are exposed to a complex mix of man-made electric and magnetic fields (MFs) at many different frequencies, at home and at work. Epidemiological studies indicate that there is a positive relationship between residential/domestic and occupational exposure to extremely low frequency electromagnetic fields and some types of cancer, although some other studies indicate no relationship. In this review, after an introduction on the MF definition and a description of natural/anthropogenic sources, the epidemiology of residential/domestic and occupational exposure to MFs and cancer is reviewed, with reference to leukemia, brain, and breast cancer. The in vivo and in vitro effects of MFs on cancer are reviewed considering both human and animal cells, with particular reference to the involvement of reactive oxygen species (ROS). MF application on cancer diagnostic and therapy (theranostic) are also reviewed by describing the use of different magnetic resonance imaging (MRI) applications for the detection of several cancers. Finally, the use of magnetic nanoparticles is described in terms of treatment of cancer by nanomedical applications for the precise delivery of anticancer drugs, nanosurgery by magnetomechanic methods, and selective killing of cancer cells by magnetic hyperthermia. The supplementary tables provide quantitative data and methodologies in epidemiological and cell biology studies. Although scientists do not generally agree that there is a cause-effect relationship between exposure to MF and cancer, MFs might not be the direct cause of cancer but may contribute to produce ROS and generate oxidative stress, which could trigger or enhance the expression of oncogenes.
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Yin M, Yang L, Wang Y. Gastric-type endocervical adenocarcinoma with mucoepithelial metaplasia combined with a serous borderline tumor: A case report. Medicine (Baltimore) 2021; 100:e28239. [PMID: 34941092 PMCID: PMC8702242 DOI: 10.1097/md.0000000000028239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/24/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Gastric-type endocervical adenocarcinoma (GAS) is a rare type of cervical adenocarcinoma that is a mucinous adenocarcinoma with a variety of gastral patterns. To date, there are no systematic clinical diagnosis and treatment guidelines. PATIENT CONCERNS In our case, a 49-year-old woman underwent pelvic magnetic resonance imaging (MRI) due to a pelvic mass, and cervical lesions were unexpectedly found. After receiving relevant surgical treatment, the pathological results showed the particularity of the tumor type-cervical gastric adenocarcinoma with a borderline serous tumor of both appendages and the right ovary. DIAGNOSES Postoperative routine pathological examination showed mucoepithelial metaplasia accompanied by a borderline serous tumor. INTERVENTIONS After gynecological/urinary ultrasound, blood tests, MRI, cervical biopsy, and uterine curettage, "robot-assisted laparoscopic radical hysterectomy + bilateral salpingectomy-ovariectomy + pelvic lymph node dissection + pelvic adhesiolysis" were performed. After the surgery, the patient was treated with radiotherapy and concurrent chemotherapy. OUTCOMES After the operation, radiotherapy, and chemotherapy, the patient had no tumor recurrence and is still in good condition. LESSONS The diagnosis of GAS is relatively difficult, its clinical manifestations lack specificity, and the pathogenesis has nothing to do with human papillomavirus infection. The patient was misdiagnosed with vaginitis at a local hospital. However, we found that MRI and pathological examination were helpful for the diagnosis of the disease. Although there are no relevant guidelines to explain the treatment principles of GAS, we believe that early surgery is conducive to the prognosis of the disease because GAS has a certain tolerance to radiotherapy and chemotherapy.
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Affiliation(s)
- Man Yin
- Department of Clinical Medicine, Jining Medical University, Jining, Shandong, China
| | - Linqing Yang
- Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Yunfei Wang
- Affiliated Hospital of Jining Medical University, Jining, Shandong, China
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Liu Y, Song T, Dong TF, Zhang W, Wen G. MRI-based radiomics analysis to evaluate the clinicopathological characteristics of cervical carcinoma: a multicenter study. Acta Radiol 2021; 64:395-403. [PMID: 34918963 DOI: 10.1177/02841851211065142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND Preoperative prediction of clinical pathological indicators of cervical cancer (CC) is of great significance to the formulation of personalized treatment plans for CC. PURPOSE To investigate magnetic resonance imaging (MRI) radiomics analysis for the evaluation of pathological types, tumor grade, FIGO stage, and lymph node metastasis (LNM) of CC. MATERIAL AND METHODS A total of 235 patients with CC from three institutes were enrolled in the study. All patients underwent T2/SPAIR and contrast-enhanced T1-weighted (CE-T1WI) imaging scans before radical hysterectomy by pelvic lymph node dissection surgery. Radiomics features extracted from T2/SPAIR and CE-T1WI imaging were selected by the least absolute shrinkage and selection operator (LASSO) methods for further radiomics signature calculation. These radiomic features were used to construct regression and decision tree models to evaluate the performance of radiomic features in distinguishing clinicopathological indicators. RESULTS The area under the curve (AUC) of T2/SPAIR and CE-T1WI imaging were 0.777 and 0.750, respectively, for differentiating between adenocarcinoma and squamous cell carcinoma. From the two sequences, the AUC of the verification group that distinguished low FIGO stage from high FIGO stage was 0.716 and 0.676, respectively. The AUC for moderately well and poorly differentiated tumors were 0.729 on T2/SPAIR and 0.749 on CE-T1WI imaging. The AUC of the verification groups for LNM was 0.730 and 0.618 on T2/SPAIR and CE-T1WI imaging, respectively. CONCLUSION MRI radiomics features can be used as a non-invasive method to evaluate the clinicopathological indexes of CC and provide an important auxiliary examination method for patients to determine individualized treatment plans before operation.
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Affiliation(s)
- Yi Liu
- Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Ting Song
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, PR China
| | - Tian-Fa Dong
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, PR China
| | - Wei Zhang
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, PR China
| | - Ge Wen
- Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
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Song J, Gu Y, Du T, Liu Q. Analysis of quantitative and semi-quantitative parameters of DCE-MRI in differential diagnosis of benign and malignant cervical tumors. Am J Transl Res 2021; 13:12228-12234. [PMID: 34956449 PMCID: PMC8661164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 06/28/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore and analyze the value of quantitative and semi-quantitative parameters of dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) in the differential diagnosis of benign and malignant cervical tumors. METHODS A total of 51 patients with cervical tumor who were treated in our hospital from April 2017 to October 2019 were recruited as the research subjects. All patients underwent conventional MRI plain scan and DCE-MRI examination. With histopathological results as the gold standard, the participants were classified into a malignant tumor group (n = 36) and a benign tumor group (n = 15) on the basis of the nature of the cervical tumor. The difference of quantitative and semi-quantitative parameters of DCE-MRI between the two groups was compared, and the specificity, sensitivity, negative and positive predictive values of quantitative and semi-quantitative parameters in differentiating benign from malignant cervical tumors were analyzed to evaluate the value of quantitative and semi-quantitative parameters of DCE-MRI in the differential diagnosis of benign and malignant cervical tumors. RESULTS The quantitative parameters Kep, Ktrans and Ve of DCE-MRI in the malignant-tumor-group were critically higher than that in the benign tumor group (P<0.05). When distinguishing between the benign and malignant cervical tumors, the specificity and sensitivity of kep, Ktrans and Ve were higher in the differential diagnosis of malignant cervical tumors than in the benign cervical tumors. The peak of the malignant tumor group was remarkably earlier than that of the benign tumor group, and SI60% of the malignant tumor group was dramatically higher than that of benign tumor group (P<0.05). In addition, compared with benign cervical tumors, the semi-quantitative parameters of DCE-MR TTP and SI60% were more sensitive to malignant cervical tumors. CONCLUSION The quantitative and semi-quantitative parameters of DCE-MRI have high value in differentiating benign and malignant cervical tumors. When adopting conventional MRI to diagnose oncologic cervical tumors, the differential diagnosis of quantitative and semi-quantitative parameters of DCE-MRI has demonstrated a high clinical value by avoiding unnecessary radical surgeries.
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Affiliation(s)
- Jun Song
- Department of Radiology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of ChinaMianyang, Sichuan, China
| | - Yong Gu
- Department of Radiology, Santai Hospital, North Sichuan Medical College621100, Sichuan, China
| | - Tingting Du
- Department of Radiology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of ChinaMianyang, Sichuan, China
| | - Qiyu Liu
- Department of Radiology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of ChinaMianyang, Sichuan, China
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Dinh TKT, Parker EU, Gangadhar K, Mansoori B, Dyer BA. Management of locally advanced mesonephric carcinoma of the cervix in the setting of Mullerian Duct anomaly spectrum and unilateral renal agenesis: A case report and review of the literature. Brachytherapy 2021; 20:1180-1186. [PMID: 34521573 DOI: 10.1016/j.brachy.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/29/2021] [Accepted: 08/01/2021] [Indexed: 11/26/2022]
Abstract
Cervical mesonephric adenocarcinoma is a rare histologic cervical carcinoma variant arising from remnants of the mesonephric duct. Few clinical cases have been reported in the literature, and given the low rate of occurrence, the optimal management strategy is unknown. Most reported cases involve patients with either early stage (FIGO I) or metastatic disease. Herein, we report the only known case of locally advanced, node-positive cervical mesonephric carcinoma in a 55-year old woman with Mullerian duct anomaly of the uterus, obstructed hemivagina, and ipsilateral renal agenesis. To our knowledge, this would be the first case report with the concurrence of both rare entities. We review the treatment paradigm in this patient, and the literature, including radiotherapy and brachytherapy techniques.
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Affiliation(s)
- Tru-Khang T Dinh
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - Elizabeth U Parker
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Kiran Gangadhar
- Department of Radiology, Abdominal Imaging Division, University of Washington, Seattle, WA
| | - Bahar Mansoori
- Department of Radiology, Abdominal Imaging Division, University of Washington, Seattle, WA
| | - Brandon A Dyer
- Department of Radiation Oncology, University of Washington, Seattle, WA.
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Li S, Zhang Z, Liu J, Zhang F, Yang M, Lu H, Zhang Y, Han F, Cheng J, Zhu J. The feasibility of a radial turbo-spin-echo T2 mapping for preoperative prediction of the histological grade and lymphovascular space invasion of cervical squamous cell carcinoma. Eur J Radiol 2021; 139:109684. [PMID: 33836336 DOI: 10.1016/j.ejrad.2021.109684] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/05/2021] [Accepted: 03/25/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE The study aimed to analyze the feasibility of a radial turbo-spin-echo (TSE) T2 mapping to differentiate the histological grades and lymphovascular space invasion (LVSI) of cervical squamous cell carcinoma (CSCC) in comparison with diffusion-weighted imaging (DWI). METHODS A total of 58 patients with CSCC and 40 healthy volunteers underwent T2 mapping and DWI before therapy. The T2 and apparent diffusion coefficient (ADC) values were calculated using different tumor characteristics. The differences, efficacies and correlations between parameters were determined. RESULTS The T2 and ADC values were significantly different between CSCC and normal cervical stroma (both p < 0.05). Poorly differentiated (G3) tumor showed lower T2 and ADC values than well differentiated (G1) and moderately differentiated (G2) tumor (all p < 0.05). The T2 values were significantly lower in LVSI-positive CSCC than LVSI-negative CSCC (p < 0.05). No significant difference was found in ADC values for LVSI status (p = 0.561). The area under the ROC (AUC) for T2 and ADC values to distinguish G1/G2 and G3 tumor were 0.741 and 0.763, respectively. The AUC for T2 and ADC values to distinguish LVSI-positive and LVSI-negative CSCC were 0.877 and 0.537, respectively. The T2 and ADC values were negatively correlated with the tumor grades (r = -0.402 and r = -0.339, respectively). CONCLUSIONS Radial TSE T2 mapping is feasible for CSCC. Similar to ADC values, quantitative T2 values could serve as a noninvasive biomarker to predict histological grades preoperatively. Moreover, T2 values could determine the presence of LVSI better than ADC values.
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Affiliation(s)
- Shujian Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zanxia Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jie Liu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Feifei Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Meng Yang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huifang Lu
- Department of Gynecology and Obstetrics, Huaihe Hospital of Henan University, Kaifeng, China
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fei Han
- MR R&D Collaboration, Siemens Healthineers, Los Angeles, CA, USA
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthcare Ltd., Beijing, China
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An unusual presentation of usual-type endocervical adenocarcinoma with lobular endocervical glandular hyperplasia: A case report. Case Rep Womens Health 2021; 30:e00297. [PMID: 33665139 PMCID: PMC7903295 DOI: 10.1016/j.crwh.2021.e00297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 11/21/2022] Open
Abstract
Uterine cervical hematoma is rare. A 51-year-old woman underwent pelvic magnetic resonance imaging (MRI) for uterine tumor survey. A large hematoma with cystic and solid lesions was observed in the uterine cervix. Follow-up MRI after 5 days revealed that the hematoma had decreased in volume. Pathological examination after surgery suggested there was usual-type endocervical adenocarcinoma (UEA) in the lower cervix and lobular endocervical glandular hyperplasia (LEGH) in the upper cervix, along with the cervical hematoma. The findings of this case suggest that the uterine cervical hematoma was secondary to either UEA or LEGH. Uterine cervical hematoma is rare. In the present case, the hematoma was considered to be caused by either the usual-type endocervical adenocarcinoma or lobular endocervical glandular hyperplasia. The exact mechanism of the hematoma formation was unclear. Usual-type endocervical adenocarcinoma and lobular endocervical glandular hyperplasia can be considered as differential diagnosis in cases of cervical hematoma.
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Boria F, Siegrist J, Hardisson D, Saturio N, Zapardiel I. Lobular endocervical glandular hyperplasia mimicking cervical adenocarcinoma. J OBSTET GYNAECOL 2020; 41:1166-1168. [PMID: 33236941 DOI: 10.1080/01443615.2020.1820969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Felix Boria
- Gynecologic Oncology Unit, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Jaime Siegrist
- Gynecologic Oncology Unit, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - David Hardisson
- Department of Pathology, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Nuria Saturio
- Department of Radiology, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, IdiPAZ, Madrid, Spain
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20
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Liu S, Guo Y, Li B, Zhang H, Zhang R, Zheng S. Analysis of Clinicopathological Features of Cervical Mucinous Adenocarcinoma with a Solitary Ovarian Metastatic Mass as the First Manifestation. Cancer Manag Res 2020; 12:8965-8973. [PMID: 33061592 PMCID: PMC7522420 DOI: 10.2147/cmar.s270675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 08/26/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose To avoid misdiagnosis, clinicopathological features were analyzed in cases of cervical mucinous adenocarcinoma with solitary ovarian metastatic masses. Patients and Methods Three cases misdiagnosed as primary ovarian adenocarcinoma before surgery were filtered from the database of the Cancer Hospital/Chinese Academy of Medical Sciences from January 1998 to December 2016. The clinical data were thoroughly collected and compared, and both frozen and paraffin-embedded pathological sections were reviewed by two expert pathologists. Results None of the patients experienced cervical contact bleeding, and no typical cervical neoplasms were found. The cervical canals were slightly thickened in two patients, as detected by either palpation or imaging. The high-risk human papillomavirus (HPV) test results were all negative, and the thin-prep cytologic test (TCT) screened only one case of atypical glandular epithelial cells. All cases were indicative of higher serum CA19-9 levels (79.49-6124 U/mL). The ovarian masses showed no regular laterality, while they were all cystic or solid-cystic. Their pathological sections indicated a benign appearance of the capsule tissue with well-differentiated mucinous glands infiltrating the ovarian cortex with focal necrosis. Conclusion Attention should be paid to cervical examinations before and during surgery for cervical mucinous adenocarcinoma with a metastatic ovarian mass as the first manifestation. Such patients may gain a better prognosis after active treatment.
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Affiliation(s)
- Shuanghuan Liu
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yunquan Guo
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.,Department of Pathology, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi, People's Republic of China
| | - Bin Li
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Huijuan Zhang
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Rong Zhang
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Shan Zheng
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
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Mulita F, Iliopoulos F, Kehagias I. A rare case of gastric-type mucinous endocervical adenocarcinoma in a 59-year-old woman. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2020; 19:147-150. [PMID: 33100952 PMCID: PMC7573334 DOI: 10.5114/pm.2020.99563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/30/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Endocervical adenocarcinoma represents 20-25% of the histological types of cervical carcinoma. Gastric-type mucinous adenocarcinoma of the cervix is a rare type of cancer with aggressive behavior. This type of malignancy is not related to high-risk human papillomavirus (HPV). CASE REPORT We report a 59-year-old postmenopausal woman complaining of vaginal bleeding and pelvic pain. Histological analysis of punch biopsy and endocervical curettage revealed possible endocervical mucinous adenocarcinoma, while magnetic resonance imaging (MRI) revealed a 10 × 8 cm sized cervical mass. According to oncologists, the tumor was inoperable, so the patient received 6 cycles of chemotherapeutic agents with carboplatin, paclitaxel and bevacizumab from December 2019 to March 2020. However, chemotherapy had very poor results in this patient, because the mass was increased to 24 cm in a new MRI performed after the end of chemotherapy. Finally, the patient underwent radical surgery. On histopathological examination, the surgical margin was all free from everywhere and the mass was confirmed as a gastric-type mucinous adenocarcinoma of the cervix with low differentiation. CONCLUSION It is very important to have an early diagnosis of gastric-type mucinous adenocarcinoma of the cervix, as this tumor is poorly symptomatic and very aggressive. When chemotherapy is not effective, radical surgery may be a solution for better survival.
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Affiliation(s)
- Francesk Mulita
- Corresponding author: Francesk Mulita, Department of Surgery, General University Hospital of Patras, Pio 265 04, Greece, e-mail:
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Ma Z, Chen J, Luan T, Chu C, Wu W, Zhu Y, Gu Y. Proteomic analysis of human cervical adenocarcinoma mucus to identify potential protein biomarkers. PeerJ 2020; 8:e9527. [PMID: 33194326 PMCID: PMC7394065 DOI: 10.7717/peerj.9527] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/21/2020] [Indexed: 12/24/2022] Open
Abstract
Background Cervical cancer is the most common gynecological cancer, encompassing cervical squamous cell carcinoma, adenocarcinoma, and other epithelial tumors. There are many diagnostic methods to detect cervical cancers but no precision screening tool for cervical adenocarcinoma at present. Material and methods The cervical mucus from three normal cervices (Ctrl), three endocervical adenocarcinoma (EA), and three cervical adenocarcinoma in situ (AIS) was collected for proteomic analysis. The proteins were screened using liquid chromatography-mass spectrometry analysis (LC-MS). The biological function of the differently expressed proteins were predicted by Gene Ontology (GO). Results A total of 711 proteins were identified, including 237 differently expressed proteins identified in EA/Ctrl comparison, 256 differently expressed proteins identified in AIS/Ctrl comparison, and 242 differently expressed proteins identified in AIS/EA comparison (up-regulate ≥ 1.5 or down-regulate ≤ 0.67). Functional annotation was performed using GO analysis on 1,056 differently expressed proteins to identify those that may impact cervical cancer, such as heme protein myeloperoxidase, which is involved in the immune process, and APOA1, which is associated with lipid metabolism. Conclusion We used proteomic analysis to screen out differently expressed proteins from normal cervical mucus and cervical adenocarcinoma mucus samples. These differently expressed proteins may be potential biomarkers for the diagnosis and treatment of cervical adenocarcinoma but require additional study.
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Affiliation(s)
- Zhifang Ma
- Department of Pathology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Jie Chen
- Department of Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Ting Luan
- Department of Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Chengzhuo Chu
- Department of Pathology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Wangfei Wu
- Department of Pathology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Yichao Zhu
- Department of Physiology, Nanjing Medical University, Nanjing, China.,State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China
| | - Yun Gu
- Department of Pathology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
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