Primary vaginal adenocarcinoma of intestinal type arising from an adenoma: case report and review of the literature.
A 1 cm polypoid lesion was encountered on the posterior vaginal wall in a 56-year-old woman with no history of diethylstilbestrol exposure that on microscopic examination was a moderately differentiated adenocarcinoma of intestinal type. The tumor was cytokeratin 20 and carcinoembryonic antigen positive and negative for cytokeratin 7. Mucin histochemistry demonstrated the presence of o-acetylated sialomucin, a specific marker of large intestinal differentiation. The initial interpretation favored a metastasis from a colonic adenocarcinoma, but clinical investigations showed no evidence of a primary gastrointestinal lesion. The morphology, histochemical, and differential cytokeratin profile led to the lesion being reinterpreted as a primary intestinal-type adenocarcinoma of the vagina arising from a tubular adenoma. Although a very rare tumor, awareness of this lesion is important as it must be distinguished from metastatic adenocarcinomas from other sites.
Mudhar
H S
HS
Department of Histopathology, Northern General Hospital, Herries Road, Sheffield S5 7AU, United Kingdom.
Smith
J H
JH
Tidy
J
J
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000473:pathology*; D002272:Carcinoembryonic Antigen / Q000032:analysis; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms; D007633:Keratins / Q000032:analysis; D008875:Middle Aged; D009077:Mucins / Q000032:analysis; D009852:Omentum / Q000601:surgery; D010052:Ovariectomy; D014625:Vaginal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
D002272:Carcinoembryonic Antigen; D009077:Mucins; D007633:Keratins