A case of adenocarcinoma of the endometrial type mixed with a clear cell component that metastasized to the vagina.
We present a patient with adenocarcinoma of the endometrial type mixed with a clear cell component (AMC) that metastasized to the vagina and one of the pelvic lymph nodes. She underwent a radical hysterectomy and pelvic and paraaortic lymphadenectomy, and then received postoperative adjuvant chemotherapy. Histologic features of the endometrial tumor included clear cell adenocarcinoma with an approximate 10% extent to endometrioid adenocarcinoma. On the other hand, histologic examination on the vaginal tumor predominatly showed clear cell adenocarcinoma and also revealed endometrioid adenocarcinoma to a very small extent, suggesting metastasis to the vagina from AMC. On immunohistochemical examination, expression of vascular endothelial growth factor (VEGF)-A, VEGF-C and VEGF-D was apparently stronger in the component of clear cell adenocarcinoma than in that of endometrioid adenocarcinoma. She has been a disease-free survivor for 26 months. Interestingly, locations of endometrial and vaginal lesions were consistent with the sites of an intrauterine device and ring pessary insertion, respectively.
Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Hirosaki, Japan.
Y
Y
Yokoyama
A
A
Sakamoto
M
M
Umemoto
M
M
Futagami
T
T
Sakamoto
H
H
Maruyama
S
S
Sato
H
H
Mizunuma
D018262:Adenocarcinoma, Clear Cell / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D000368:Aged; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D010388:Pelvis; D014625:Vaginal Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery