Abstract
The occurrence of a secondary malignancy in the uterine cervix is a very rare event. In the vast majority of cases, this secondary involvement concerns direct spread of a uterine malignancy to the cervix. However, cancer of the ovary, breast, stomach, gallbladder, pancreas and lung has been reported to metastasize to the uterine cervix by hematogenous route. In this context, secondary lesions of the uterine cervix, in particular those of non-epithelial and extra-genital origin, are sufficiently rare to be overlooked, which might result in inappropriate diagnosis with disappointing consequences in terms of treatment planning. We report a single-institution consecutive series of 144 cases of secondary malignancy of the uterine cervix, emphasizing the morphological and immunohistochemical criteria required to arrive at a correct final diagnosis. Secondary malignancies of the uterine cervix have a protean appearance and can present with a wide spectrum of symptoms. Almost invariably metastases to the cervix signal devastating spread to many different organs. Histopathology, as well as immunohistochemical features and close collaboration between clinicians and pathologists, is essential to arrive at a correct final diagnosis.
Similar content being viewed by others
References
Nystrom JS, Weiner JM, Heffelfinger-Juttner J, Irwin LE, Bateman JR, Wolf RM (1977) Metastatic and histologic presentations in unknown primary cancer. Semin Oncol 4:53–58
Lemoine NR, Hall PA (1986) Epithelial tumors metastatic to the uterine cervix. A study of 33 cases and review of the literature. Cancer 57:2002–2005
Mulvany NJ, Nirenberg A, Oster AG (1996) Non-primary cervical adenocarcinomas. Pathology 28:293–297
McCluggage WG, Hurrell DP, Kennedy K (2010) Metastatic carcinomas in the cervix mimicking primary cervical adenocarcinoma and adenocarcinoma in situ: report of a series of cases. Am J Surg Pathol 34:735–741
Malpica A, Deavers MT (2011) Ovarian low-grade serous carcinoma involving the cervix mimicking a cervical primary. Int J Gynecol Pathol 30:613–619
Bogliolo S, Morotti M, Valenzano Menada M, Fulcheri E, Musizzano Y, Casabona F (2010) Breast cancer with synchronous massive metastasis in the uterine cervix: a case report and review of the literature. Arch Gynecol Obstet 281:769–773
Green AE, Biscotti C, Michener C, Belinson J (2004) Isolated cervical metastasis of breast cancer: a case report and review of the literature. Gynecol Oncol 95:267–269
Imachi M, Tsukamoto N, Amagase H, Shigematsu T, Amada S, Nakano H (1993) Metastatic adenocarcinoma to the uterine cervix from gastric cancer. A clinicopathologic analysis of 16 cases. Cancer 71:3472–3477
Kai K, Takai N, Nasu K, Kira N, Ishii T, Kashima K, Narahara H (2009) Metastatic uterine cervical cancer originating in the lung: a case report. Gynecol Obstet Invest 68:269–271
Mazur MT, Hsueh S, Gersell DJ (1984) Metastases to the female genital tract. Analysis of 325 cases. Cancer 53:1978–1984
Kumar NB, Hart WR (1982) Metastases to the uterine corpus from extragenital cancers. A clinicopathologic study of 63 cases. Cancer 50:2163–2169
Sherman ME, Wang SS, Carreon J, Devesa SS (2005) Mortality trends for cervical squamous and adenocarcinoma in the United States. Relation to incidence and survival Cancer 103:1258–1264
Witkiewicz AK, Knudsen KE, Dicker AP, Knudsen ES (2011) The meaning of p16(ink4a) expression in tumors: functional significance, clinical associations and future developments. Cell Cycle 10:2497–2503
Reid-Nicholson M, Iyengar P, Hummer AJ, Linkov I, Asher M, Soslow RA (2006) Immunophenotypic diversity of endometrial adenocarcinomas: implications for differential diagnosis. Mod Pathol 19:1091–1100
Fadare O (2006) Uncommon sarcomas of the uterine cervix: a review of selected entities. Diagn Pathol 1:30
Grayson W, Taylor LF, Cooper K (2001) Carcinosarcoma of the uterine cervix: a report of eight cases with immunohistochemical analysis and evaluation of human papillomavirus status. Am J Surg Pathol 25:338–347
Raspollini MR, Baroni G, Taddei A, Taddei GL (2003) Primary cervical adenocarcinoma with intestinal differentiation and colonic carcinoma metastatic to cervix: an investigation using Cdx-2 and a limited immunohistochemical panel. Arch Pathol Lab Med 127:1586–1590
Conflict of interest
The authors have no relevant conflict of interest to disclose.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zannoni, G.F., Vellone, V.G., Petrillo, M. et al. Secondary malignancies of the uterine cervix: a potential diagnostic pitfall. Virchows Arch 463, 23–29 (2013). https://doi.org/10.1007/s00428-013-1436-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00428-013-1436-y