Liu Shuanghuan, Guo Yunquan, Li Bin, Zhang Huijuan, Zhang Rong, Zheng Shan
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.
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.
Cancer Manag Res. 2020 Sep 24;12:8965-8973. doi: 10.2147/CMAR.S270675. eCollection 2020.
To avoid misdiagnosis, clinicopathological features were analyzed in cases of cervical mucinous adenocarcinoma with solitary ovarian metastatic masses.
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.
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.
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.
分析以孤立性卵巢转移肿块为表现的宫颈黏液腺癌的临床病理特征，以避免误诊。
从1998年1月至2016年12月中国医学科学院肿瘤医院数据库中筛选出3例术前误诊为原发性卵巢腺癌的病例。全面收集并比较临床资料，由两位专家病理学家对冰冻及石蜡包埋病理切片进行复查。
所有患者均无宫颈接触性出血，未发现典型宫颈肿物。两名患者经触诊或影像学检查发现宫颈管轻度增厚。高危型人乳头瘤病毒（HPV）检测结果均为阴性，薄层液基细胞学检测（TCT）仅筛查出1例非典型腺上皮细胞。所有病例血清CA19-9水平均较高（79.49 - 6124 U/mL）。卵巢肿块无固定侧别，均为囊性或囊实性。病理切片显示包膜组织外观良性，高分化黏液性腺癌浸润卵巢皮质，伴有局灶性坏死。
对于以卵巢转移肿块为首发表现的宫颈黏液腺癌患者，手术前后均应重视宫颈检查。积极治疗后此类患者可能获得较好预后。
