Qian Xue-Qian, Wang Fen-Fen, Liang Yun, Chen Li-Li, Wan Xiao-Yun
Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Front Surg. 2022 Jul 4;9:945984. doi: 10.3389/fsurg.2022.945984. eCollection 2022.
Gastric-type mucinous carcinoma (GAS), as a rare subtype of mucinous adenocarcinoma, accounts for approximately 1%-3% of cervical adenocarcinoma. It was considered as a new type of cervical mucinous adenocarcinoma by the World Health Organization (WHO) in 2014. GAS represents more aggressive disease than does usual type endocervical adenocarcinoma (UEA).
A case of cervical adenocarcinoma with an abnormal increase of CA199 in a 50-year-old Chinese woman was reported. Our patient presented with abnormal vaginal discharge and combined with elevated Ca199 at the value of 2,729 U/mL. Imaging examinations showed no abnormalities. Diagnostic conical resection suggested cervical adenocarcinoma . Post-operative pathology confirmed mucinous cervical adenocarcinoma (considering gastric type), infiltrating cervical interstitial >2/3, involving the deep myometrium, accompanied by vascular carcinoma infiltration and lymph node metastasis.The patients received an extensive hysterectomy and post-operative adjuvant chemoradiotherapy. The chemotherapy regimen was paclitaxel, combined with platinum. After 20 months of follow-up, the patient showed no signs of recurrence.
Preoperative diagnosis of cervical adenocarcinoma is insidious and can be easily misdiagnosed. For patients with high preoperative Ca199, the possibility of GAS should be kept open.
胃型黏液腺癌(GAS)是黏液腺癌的一种罕见亚型,约占宫颈腺癌的1%-3%。2014年世界卫生组织(WHO)将其视为一种新型宫颈黏液腺癌。与普通型宫颈内膜腺癌(UEA)相比,GAS的病情更具侵袭性。
报告一例50岁中国女性宫颈腺癌伴CA199异常升高的病例。我们的患者表现为阴道分泌物异常,且CA199升高至2729 U/mL。影像学检查未发现异常。诊断性锥形切除术提示宫颈腺癌。术后病理证实为黏液性宫颈腺癌(考虑胃型),宫颈间质浸润>2/3,累及子宫肌层深部,伴有血管癌浸润和淋巴结转移。患者接受了广泛子宫切除术及术后辅助放化疗。化疗方案为紫杉醇联合铂类。随访20个月后,患者无复发迹象。
宫颈腺癌术前诊断隐匿,容易误诊。对于术前CA199升高的患者,应考虑胃型黏液腺癌的可能性。