Wang Yongxin, Shan Xue, Li Man, Yue Ying
Department of Gynecologic Oncology, The First Hospital of Jilin University, Changchun, China.
Department of Cardiac Surgery, The First Hospital of Jilin University, Changchun, China.
Front Surg. 2022 Mar 9;9:841255. doi: 10.3389/fsurg.2022.841255. eCollection 2022.
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.
宫颈腺癌可表现为宫颈管内实性、实性混合、囊性或多个囊性宫颈肿物。在本报告中，我们呈现了一例极为罕见的伴有巨大囊性病变的宫颈腺癌病例。一名月经周期规律的37岁中国女性因轻度腹胀前往当地医生处就诊。腹部超声检查提示卵巢囊肿，其平均直径在3个月内从3厘米增至8厘米。此后，她被转诊至我院。她无异常阴道出血或分泌物。经阴道超声检查显示子宫后方有一个95×80毫米的囊肿。计算机断层扫描显示宫颈与右卵巢之间有一个9.8×8.5厘米的多房性囊肿。人乳头瘤病毒（HPV）-E6和-E7 mRNA检测显示HPV-16阳性。宫颈薄层液基细胞学检查结果为阴性。宫颈活检组织病理学检查未发现肿瘤病变。术前该病变被误诊为卵巢囊肿。术中观察到一个如儿童头部大小的囊肿从子宫后壁下部延伸至宫颈后唇，遂切除宫颈囊肿。组织学检查显示为宫颈腺癌。随后，她接受了广泛子宫切除术、双侧输卵管切除术和盆腔淋巴结清扫术。最终诊断为IB3期宫颈腺癌。随访21个月后，未发现临床或影像学复发证据。
