title: Clear Cell Carcinoma of the Uterine Cervix Presented as a Submucosal Tumor Arising in a Background of Cervical Endometriosis.
abstract: Clear cell carcinoma (CCC) of the uterine cervix without prenatal diethylstilbestrol exposure is rare, and its etiology is unclear. We present a case of cervical CCC presenting as a submucosal tumor, which strongly suggests an association between cervical endometriosis and cervical CCC. A 56-year-old postmenopausal Japanese woman visited a gynecologic clinic with a complaint of watery vaginal discharge. A few atypical cells suggesting adenocarcinoma were detected in a cervical cytologic specimen. Magnetic resonance imaging revealed a cystic lesion with a solid component at the uterine cervix. Under a tentative diagnosis of cervical cancer, surgery was performed. Although a freshly resected specimen initially showed no tumorous lesion in the cervical mucosa, cutting of the mucosa revealed a solid tumor with a final diagnosis of CCC. The findings of aggregation of hemosiderin-laden macrophages and ectopic endometrium adjacent to the tumor strongly suggest that this tumor arose from cervical endometriosis.
authors.affiliation: Departments of Pathology & Microbiology (M.H., S.A.) Obstetrics & Gynecology (M.H., S.N., Y.N., M.Y.), Saga University Faculty of Medicine Department of Pathology, Saga University Hospital (K.K., S.A.), Saga, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Hashiguchi
authors.forename: Keita
authors.initials: K
authors.lastname: Kai
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishiyama
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Nakao
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Yokoyama
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aishima
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D002584:Cervix Uteri / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D004715:Endometriosis / Q000150:complications / Q000473:pathology*; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary* / Q000601:surgery