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Abstract
Introduction/Background Adenoid basal carcinoma (ABC) is an extremely rare neoplasm of the cervix and is seen less than 1% of all cervical malignancies. It can be seen pure or combined with cervical dysplasia or other types of cervical carcinoma. Fewer than 20 cases of ABC with invasive squamous cell carcinoma (mixed carcinoma) have been described in English literature to date.
Methodology Here we present a 37-year-old female who had complaints of spotting and post-coital bleeding for 6 months. Her last pap-smear, 2 years ago, was negative for dysplasia or malignancy. Vaginal palpation revealed a barrel-shape cervix and endocervical curettage and endometrial biopsy were performed.
Results Initial pathology results revealed invasive squamous cell carcinoma. MRI showed an endocervical mass 36 × 25 mm in size with stromal invasion without parametrial invasion (figure 1). According to the criteria of the International Federation of Gynecology and Obstetrics, our case was staged as IB1.The patient underwent type 3 radical hysterectomy, bilateral salpingectomy, unilateral oophorectomy, pelvic lymphadenectomy and para-aortic lymph node sampling. Macroscopic evaluation of the histological material revealed a tumor surface of 3,5 × 3,5 × 1,5 cm in size that dilated the cervix to a barrel-shape. Approximately 50% of non-keratinized less differentiated squamous cell carcinoma with 50% of adenoid basal carcinoma were observed (figure 2). Focal reaction with CEA,p63, Bcl-2, cytokeratin 8 and a strong reaction with p16 were observed. In our case, 11 types of HPV (6,11,16,18,31,33,42,51,52,56,58) were not detected either in the squamous cell carcinoma component or adenoid basal carcinoma component.
Conclusion The invasive component of the mixed cervical carcinoma with ABC determines the staging and prognosis. So, we should keep in mind rare mixed cervical carcinoma types when we are doing pathological evaluation of the carcinoma not to overestimate the size of the tumor.
Disclosure Nothing to disclose.
MRI image of cervical mass
Microscopic examination of mixed carcinoma