Pathological features of gastric‑type endocervical adenocarcinoma: A report of two cases

Zhou,Jiahui; Zhang,Xiangning; Mao,Weibo; Zhu,Yiling; Yan,Liping; Jiang,Jiangle; Zhang,Min

doi:10.3892/ol.2024.14282

Pathological features of gastric‑type endocervical adenocarcinoma: A report of two cases

Authors:
- Jiahui Zhou
- Xiangning Zhang
- Weibo Mao
- Yiling Zhu
- Liping Yan
- Jiangle Jiang
- Min Zhang
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Affiliations: Department of Pathology, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China, Department of Pathophysiology, School of Basic Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, P.R. China
Published online on: February 9, 2024 https://doi.org/10.3892/ol.2024.14282
Article Number: 149
Copyright: © Zhou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Gastric‑type endocervical adenocarcinoma (GEA) is an uncommon form of uterine cervical adenocarcinoma with an unfavorable prognosis. The tumor consists of glands exhibiting a morphological resemblance to gastric cells and occasionally manifests features akin to pancreaticobiliary mucinous adenocarcinoma. GEA differs from the typical cervical cancer, particularly in its lack of association with the human papillomavirus. Immunophenotypic analysis suggests intestinal differentiation. The present study reports two cases of GEA occurring in postmenopausal individuals who were diagnosed in Lishui Central Hospital (Lishui, China) between January 2015 and January 2023. Microscopic examination revealed cysts lined with mucinous cells within the tumors. Immunohistochemical assays confirmed the positivity of the tumors for cytokeratin 7, mucin (MUC)5AC, and mutant tumor protein p53, while the results were negative for tumor suppressor p16, and in one case for paired box protein 8, consistent with characteristics of mucinous adenocarcinoma originating from the gastrointestinal tract. Programmed death‑ligand 1 expression was also negative. The proto‑oncogene K‑ras was identified using amplification refractory mutation system polymerase chain reaction. Both cases were negative for mutations in codons 12 and 13 of exon 2, codon 61 of exon 3 and codon 146 of exon 4, but were positive for wild‑type K‑ras. Clinical follow‑up revealed a potential association between histopathological features and resistance to chemotherapeutic drugs. The infrequency of this tumor type may contribute to diagnostic challenges.

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