title: Endocervical gastric-type adenocarcinoma, an unrelated HPV tumour: difficulties in screening and diagnosis.
abstract: Gastric-type adenocarcinoma of the cervix (GAS) is an uncommon and aggressive tumour unrelated to human papillomavirus (HPV) infection with distinctive histological and immunohistochemical characteristics. GAS may be associated with lobular endocervical glandular hyperplasia (LEGH), another unusual lesion. We report a case of a 59-year-old woman with screening cytology 'AGC-Neo' and cervical conisation exhibiting cervical intraepithelial neoplasia grade 1, extensive LEGH and canal sampling with abundant mucinous cells. Based on the possible association between LEGH and GAS, a total hysterectomy was performed. The histological diagnosis revealed a morphological gradient of lesions: LEGH, minimal deviation adenocarcinoma and GAS with lymphatic invasion. Immunohistochemistry revealed strong MUC6 expression and no p16 staining. After pelvic radiotherapy, the patient continues follow-up evaluation. The diagnostic difficulties of GAS and its relationship with LEGH are discussed. This rare tumour is important because it is poorly symptomatic and potentially aggressive. In addition, the methods for cancer control related to HPV do not affect this tumour.
authors.affiliation: Tocoginecology, Universidade Estadual de Campinas Faculdade de Ciencias Medicas, Campinas, Brazil.
authors.forename: Priscila Carneiro
authors.initials: PC
authors.lastname: Lima
authors.affiliation: Tocoginecology, Universidade Estadual de Campinas Faculdade de Ciencias Medicas, Campinas, Brazil juliotex@uol.com.br.
authors.forename: Julio
authors.initials: J
authors.lastname: Teixeira
authors.affiliation: Tocoginecology, Universidade Estadual de Campinas Faculdade de Ciencias Medicas, Campinas, Brazil.
authors.forename: Guilherme Nogueira
authors.initials: GN
authors.lastname: Aires
authors.affiliation: Pathology, Universidade Estadual de Campinas Faculdade de Ciencias Medicas, Campinas, Brazil.
authors.forename: Liliana De Angelo
authors.initials: LA
authors.lastname: Andrade
mesh_terms: D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D007044:Hysterectomy; D008875:Middle Aged; D035583:Rare Diseases; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery
keywords: Cancer - see Oncology; Cervical cancer; Cervical screening