Case Review: Gastric-Type Adenocarcinoma of the Uterine Cervix and Precursor Lesions

Abstract

Abstract A case of gastric-type endocervical adenocarcinoma that was originally diagnosed as possibly of endometrial or pancreatobiliary/upper gastrointestinal tract origin is reported. This report reviews the pertinent medical literature, differential diagnoses, etiology, and pitfalls of this disease, as well as use of immunohistochemistry and human papillomavirus (HPV) testing in establishing the diagnosis. The morphology of these tumors can range from extremely well differentiated (minimal deviation adenocarcinoma) to poorly differentiated, and therefore, the differential diagnosis can be quite varied. On one end of the spectrum, the tumor can be difficult to differentiate from benign endocervical glands, whereas at the other end, it can be difficult to determine the origin of the tumor. Because these tumors are not associated with HPV infection, the use of ancillary studies such as p16 can be misleading, and these may not be detected on standard Papanicolaou cytology with HPV screening. Molecular testing was also performed in this case with a TP53 hotpot mutation detected, along with mutations in ELF3 and PTPRS.