Introduction/Background Endocervical Gastric-type mucinous adenocarcinoma is a rare but recognised subtype of mucinous adenocarcinoma as per the WHO 2014 classification of endocervical adenocarcinomas. Although adenocarcinomas are less common than squamous cell carcinomas, their prevalence is increasing. It is important to distinguish the Gastric type from other endocervical adenocarcinomas as it is has a worse prognosis. Compared to other types of endocervical adenocarcinomas, chemotherapy may be less effective in the gastric-type. Of note, adenocarcinomas are not associated with HPV infection. With increasing uptake worldwide of primary HPV based screening for cervical cancers, diagnosis of non-HPV related cervical cancers might be missed.
Methodology A retrospective review of clinicopathologic features in patients with endocervical Gastric-type mucinous adenocarcinoma diagnosed between 2015 and 2019 in a single tertiary referral centre in Singapore.
Results 15 patients were diagnosed with endocervical Gastric-type mucinous adenocarcinoma between 2015 and 2019 with the average age of 56.4 years. 13 patients underwent examination under anaesthesia and clinical staging. Seven (53.8%) had Stage 1 disease,four (30.8%) had Stage 2 disease, one (7.7%) had Stage 3 disease and one (7.7%) had Stage 4 disease. 10 patients underwent primary treatment and follow-up our centre. 9 patients were early stage disease (Stage 1 to 2). Out of the 9 patients with early stage disease, 7 underwent surgery as primary treatment and 2 underwent radiotherapy and/or chemotherapy. 1 patient with Stage 4 disease underwent primary debulking surgery as the tumour was initially thought to be endometrial adenocarcinoma. 2 out of 10 patients have passed away from the disease during follow-up.
Conclusion The gastric subtype of cervical adenocarcinomas portends a poorer prognosis and good evidence on the optimal modality of treatment is lacking. There is need for multi-centred clinical trials to raise awareness for this rare subtype and formulate treatment options. Newer techniques incorporating molecular tests may help with the diagnosis.
Disclosure Nothing to disclose.
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