Endocervical Adenocarcinoma (EADC) Coexistent with Lobular Endocervical Glandular Hyperplasia (LEGH). A Clinicopathologic Study of 12 Cases.
Isabel Alvarado-Cabrero, Raquel Valencia-Cedillo, Monica Mohs-Alfaro. Mexican Oncology Hospital, Mexico, DF, Mexico; Hospital de Mexico, San José, Costa Rica
Background: Although LEGH was originally described as a distinct hyperplastic glandular lesion of the uterine cervix, recent studies have raised the question that LEGH may be a cancerous precursor of Minimal Deviation Adenocarcinoma (MDA) and other Mucinous Adenocarcinomas (MACs). This study was designated to evaluate the clinical and pathological data of 12 patients with EADCs, the relationship between EADCs and LEGH and the presence of Human Papilloma Virus (HPV) in both lesions.
Design: Using our Institutional database, we identified 250 stage IB EADCs between 1999 and 2009. Pathological diagnoses were reevaluated based on criteria for the diagnosis of LEGH by Nucci et al (Am J Surg Pathol 1999). HPV infection was investigate using the Polymerase Chain Reaction technique.
Results: LEGH components were present in 12 cases (5%). Of the 12 EADCs with LEGH component, 8(67%) were MDAs and 4(33%) were well-differentiated mucinous adenocarcinomas. Patient age ranged from 56 to 72 years (mean:65 years). Chief complaints were, watery and mucinous vaginal discharge in 8 cases and genital bleeding in 4 cases. To note, one patient had concurrent cervical, left ovarian mass (metastatic from the cervix) and a low-grade mucinous tumor of the appendix. Macroscopically, a diffuse (barred-shaped) or nodular enlargement of the cervix was seen in 11(92%) of the cases, multiple small cysts were seen within the nodular component. One case, was entirely cystic. Lesion size ranged from 2 to 3.8cm wide and from 1 to 2.8cm deep. The adenocarcinoma component was identified as a minor lesion within the LEGH component in all 12 cases. HPV (types 16 and 18) was positive in all cases of MACs, but negative in all LEGH and MDAs.
Conclusions: LEGH may be a cancerous precursor of MDA and other mucinous adenocarcinomas of the uterine cervix. MDA and LEGH are probably not related to HPV infection.
Category: Gynecologic & Obstetrics
Tuesday, March 1, 2011 9:30 AM
Poster Session III # 215, Tuesday Morning