Mucinous Carcinoma, Gastric Type of The Cervix

Abstract

Introduction: Mucinous carcinoma, gastric type is an uncommon variant of cervical adenocarcinoma. This variant is different with most of cervical cancers due to gastric differentiation and unrelated with HPV infection. Well differentiated form of mucinous carcinoma, gastric type sometimes is called minimal deviation adenocarcinoma or adenoma malignum. The incidence is found in almost all groups of age (25- 72 years old) with mean 42 years old. Objective: To present a new and uncommon variant case in Indonesia primarily in Medan. Case description: We reported a case of 47-year- old woman, Mrs. M, who was clinically diagnosed with suspected carcinoma of cervix. A whitish, poorly demarcated mass in cervix was found in hysterectomy specimens. Microscopic examination showed that the cervix was lined by atypical and pleomorphic columnar cells, partially forming papillary pattern. The glands were proliferated with variable sized, some of which dilated and filled with mucin, and also the glands formed back to back appearance. In some foci were found disorganized glands. Glandular epithelium lining consisted of atypical and pleomorphic columnar cells with coarse chromatin and partially prominent nucleoli. Abnormal mitoses were easily found. In some foci, tumor cells also formed solid pattern. Discussion and Conclusion: According to these histological features, a diagnosis of mucinous carcinoma, gastric type of cervix was made (ICD-0 8482/3). Despite well differentiated form of mucinous carcinoma, gastric type, this variant has aggressive behavior and worse prognosis than other cervical carcinoma variants (usual type endocervical adenocarcinoma). Mucinous carcinoma, gastric type is an uncommon variant of cervical adenocarcinoma. This type is different from most of cervical cancers due to gastric differentiation and unrelated with HPV infection. Well differentiated form of mucinous carcinoma, gastric type sometimes is called minimal deviation adenocarcinoma or adenoma malignum. The incidence was found in almost all groups of age (25-72 years old). The average age was around 42 years old. This study objective is to present a new and uncommon variant case in Indonesia primarily in Medan. This study reported a case of 47-year- old woman, Mrs. M, who was clinically diagnosed with suspected carcinoma of cervix. A whitish, poorly demarcated mass in cervix was found in hysterectomy specimens. Microscopic examination revealed that the cervix was lined by atypical and pleomorphic columnar cells, partially forming papillary pattern. The glands were proliferated with variable sized, some of which dilated and covered with mucin, and also the glands formed back to back appearance. Disorganized glands were found in some foci. Glandular epithelium lining consisted of atypical and pleomorphic columnar cells with coarse chromatin and partially prominent nucleoli. Abnormal mitoses were easily found. In some foci, tumor cells also formed solid pattern. According to these histological features, a diagnosis of mucinous carcinoma, gastric type of cervix was made (ICD-0 8482/3). Despite well differentiated form of mucinous carcinoma, gastric type, this variant had aggressive behavior and worse prognosis than other cervical carcinoma variants (usual type endocervical adenocarcinoma).