title: Secondary Involvement of the Adnexa and Uterine Corpus by Carcinomas of the Uterine Cervix: A Detailed Morphologic Description.
abstract: Cervical carcinoma infrequently involves the uterine corpus or adnexa. Metastatic adenocarcinoma (AC) to the ovaries can be difficult to distinguish from primary ovarian tumors, and metastatic squamous cell carcinoma (SCC) to these sites has not been well described. Our aim was to provide a detailed description of the morphologic patterns of adnexal and corpus involvement by cervical carcinoma. Cases were identified over a 15-yr period and the following features were recorded: visible lesion, depth of invasion, lymphovascular invasion, and patterns of spread. Only usual human papillomavirus-associated tumors were included. Twenty cases with available slides were identified (2 in situ and 8 invasive SCC; 10 AC); 17 had visible lesions, usually with deep cervical and lymphovascular invasion. Sixteen involved the corpus (1 in situ, 7 SCC, 8 AC), all colonizing endometrium and 10 invading myometrium. SCC involved the ovary and fallopian tube in 4 and 6 cases, respectively, whereas AC involved the ovary in 4 (2 unilateral, 2 bilateral) and the tube in 8 cases. SCC in the ovary usually showed parenchymal invasion, and parenchymal and mucosal involvement in the tube. AC in the ovary ranged from small nodules to confluent expansile growth, whereas in the tube it often showed mucosal colonization mimicking a primary tubal process. Adnexal metastasis of cervical carcinoma is rare and usually coexists with endometrial and myometrial extension from the cervix. Both squamous and ACs can colonize tubal and endometrial mucosa; AC in particular can mimic primaries at those sites. Bilaterality is not a common feature of metastatic endocervical AC.
authors.affiliation: Department of Gynecologic Pathology (C.R.), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania Department of Pathology (R.M.), Memorial Sloan Kettering Cancer Center, Marie-Josée and Henry R. Kravis, Center for Molecular Oncology Department of Pathology (K.J.P.), Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Carolina
authors.initials: C
authors.lastname: Reyes
authors.forename: Rajmohan
authors.initials: R
authors.lastname: Murali
authors.forename: Kay J
authors.initials: KJ
authors.lastname: Park
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary*; D000290:Adnexa Uteri / Q000473:pathology; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000556:secondary*; D005185:Fallopian Tube Neoplasms / Q000556:secondary*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000556:secondary*; D030361:Papillomavirus Infections / Q000150:complications; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014594:Uterine Neoplasms / Q000556:secondary*; D014599:Uterus / Q000473:pathology