title: Metastatic endocervical adenocarcinoma presenting as a virilizing ovarian mass during pregnancy.
abstract: BACKGROUND
  We report a case of metastatic endocervical adenocarcinoma that presented as a virilizing ovarian mass in a young pregnant woman and simulated a primary ovarian endometrioid tumor.
  
  
  METHODS
  A 34-year-old woman underwent cesarean delivery and right salpingo-oophorectomy at 34 weeks' gestation for a 32-cm androgen-producing ovarian mass. The ovarian tumor, initially interpreted as a primary ovarian endometrioid carcinoma, was demonstrated to represent metastatic endocervical endometrioid adenocarcinoma based on detection of human papillomavirus 16 (HPV-16) deoxyribonucleic acid in the tumor by in situ hybridization. The hysterectomy specimen demonstrated an endocervical adenocarcinoma associated with adenocarcinoma in situ that also contained HPV-16.
  
  
  CONCLUSIONS
  Human papillomavirus is considered an etiological agent in the development of endocervical adenocarcinomas, having been demonstrated in greater than 90% of tumors. In contrast, recent studies have concluded that HPV is unlikely to play an etiological role in ovarian neoplasia. The demonstration of HPV-16 in both the endocervical and ovarian carcinomas in this patient supports the interpretation that the ovarian tumor is a metastasis.
authors.affiliation: Department of Obstetrics & Gynecology, New Hanover Regional Medical Center, Coastal Area Health Education Center, Wilmington, North Carolina 28402-9025, USA. john.powell@coastalahec.org
authors.forename: John L
authors.initials: JL
authors.lastname: Powell
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Bock
authors.forename: Jason K
authors.initials: JK
authors.lastname: Gentry
authors.forename: Warren C
authors.initials: WC
authors.lastname: White
authors.forename: Brigitte M
authors.initials: BM
authors.lastname: Ronnett
mesh_terms: D000328:Adult; D018269:Carcinoma, Endometrioid / Q000378:metabolism / Q000556:secondary* / Q000821:virology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D009361:Neoplasm Invasiveness; D010051:Ovarian Neoplasms / Q000378:metabolism / Q000473:pathology / Q000556:secondary*; D027383:Papillomaviridae / Q000378:metabolism; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000821:virology; D014770:Virilism / Q000503:physiopathology