A sporadic gastric-type endocervical adenocarcinoma with endometrial involvement and bilateral ovarian metastasis, a case report

Abstract

•Gastric type endocervical adenocarcinoma (GAS) is rare in the United States.•GAS is an aggressive tumor and can metastasize unusual sites including peritoneal surfaces and adnexa.•Metastatic lesions can mimic benign/borderline mucinous tumors of ovaries.•There is no established standard of care for GAS.•Genetic consultation should be included in patient's management.

Fig. 1

AEndocervical lesion. Lobular endocervical glandular hyperplasia (LEGH) is in close proximity of surface epithelium and invasive carcinoma, the arrow points LEGH (20x). Inset: LEGH has well-defined borders. The lining epithelium is bland and pyloric-type mucinous epithelium (200x). 1B: There is subtle reaction to invasive carcinoma. The glands are clustered in groups. The glandular branching and irregularities are observed. The cytological atypia is minimal. The nuclei are basally located and there is abundant pink cytoplasm (100x). Inset: Gastrointestinal-type endocervical adenocarcinoma in situ. There is prominent luminal infoldings. Rare mitotic figures are present (200x). 1C: Endometrial section. The normal endometrium is replaced by gastrointestinal type epithelium. The stromal reaction is minimal (20x). Inset: Higher power view of endometrial lesions. Arrows indicate goblet-type intestinal epithelium (200x). 1D: The left ovarian cystic lesion (40x). Higher power view of lining epithelium (200x).

Fig. 2

Copy number plots of cervix (A, top) and ovary (B, bottom) tumors demonstrating overall similar copy number changes across the genome. Tumor purity of ovarian sample was lower, and therefore copy number changes are less pronounced.