Hashiguchi Mariko, Kai Keita, Nishiyama Satoshi, Nakao Yoshifumi, Yokoyama Masatoshi, Aishima Shinichi
Departments of Pathology & Microbiology (M.H., S.A.) Obstetrics & Gynecology (M.H., S.N., Y.N., M.Y.), Saga University Faculty of Medicine Department of Pathology, Saga University Hospital (K.K., S.A.), Saga, Japan.
Int J Gynecol Pathol. 2018 Jan;37(1):88-92. doi: 10.1097/PGP.0000000000000386.
Clear cell carcinoma (CCC) of the uterine cervix without prenatal diethylstilbestrol exposure is rare, and its etiology is unclear. We present a case of cervical CCC presenting as a submucosal tumor, which strongly suggests an association between cervical endometriosis and cervical CCC. A 56-year-old postmenopausal Japanese woman visited a gynecologic clinic with a complaint of watery vaginal discharge. A few atypical cells suggesting adenocarcinoma were detected in a cervical cytologic specimen. Magnetic resonance imaging revealed a cystic lesion with a solid component at the uterine cervix. Under a tentative diagnosis of cervical cancer, surgery was performed. Although a freshly resected specimen initially showed no tumorous lesion in the cervical mucosa, cutting of the mucosa revealed a solid tumor with a final diagnosis of CCC. The findings of aggregation of hemosiderin-laden macrophages and ectopic endometrium adjacent to the tumor strongly suggest that this tumor arose from cervical endometriosis.
未暴露于己烯雌酚的子宫颈透明细胞癌（CCC）罕见，其病因尚不清楚。我们报告一例表现为黏膜下肿瘤的宫颈CCC病例，这强烈提示宫颈子宫内膜异位症与宫颈CCC之间存在关联。一名56岁绝经后日本女性因水样白带就诊于妇科门诊。宫颈细胞学标本中检测到少量提示腺癌的非典型细胞。磁共振成像显示子宫颈有一个含实性成分的囊性病变。在初步诊断为宫颈癌的情况下进行了手术。尽管新鲜切除的标本最初在宫颈黏膜中未显示肿瘤病变，但切开黏膜后发现一个实性肿瘤，最终诊断为CCC。肿瘤旁含铁血黄素巨噬细胞和异位子宫内膜聚集的发现强烈提示该肿瘤起源于宫颈子宫内膜异位症。
