Mucinous carcinoma originating from uterine adenomyosis: a case report

Abstract Background Uterine adenomyosis is rarely a precursor of malignant tumors, but the most frequent histological subtype is endometrioid carcinoma. We observed a rare case of mucinous carcinoma originating from uterine adenomyosis. Case presentation A 63-year-old Japanese woman presented to our...

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Main Authors: Satoshi Ohira, Ryota Tachibana, Sayaka Yasaki, Koji Tsunemi, Natsuki Uchiyama, Eri Ikeda, Kenji Sano
Format: Article
Language:English
Published: BMC 2023-02-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s13256-023-03772-w
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author Satoshi Ohira
Ryota Tachibana
Sayaka Yasaki
Koji Tsunemi
Natsuki Uchiyama
Eri Ikeda
Kenji Sano
author_facet Satoshi Ohira
Ryota Tachibana
Sayaka Yasaki
Koji Tsunemi
Natsuki Uchiyama
Eri Ikeda
Kenji Sano
author_sort Satoshi Ohira
collection DOAJ
description Abstract Background Uterine adenomyosis is rarely a precursor of malignant tumors, but the most frequent histological subtype is endometrioid carcinoma. We observed a rare case of mucinous carcinoma originating from uterine adenomyosis. Case presentation A 63-year-old Japanese woman presented to our hospital with lower abdominal pain. She had no atypical genital bleeding. Ultrasound demonstrated thickening of the entire uterine wall, but the endometrium was not thick. Magnetic resonance imaging demonstrated an enlarged uterus with thickening of the entire uterine wall, suggesting adenomyosis. On the basis of the specimen of endocervical curettage, adenocarcinoma originating from the endometrium was suspected. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed to confirm the diagnosis. Macroscopically, the resected enlarged uterus had no nodules and exudation of mucin was observed from the cut surface of the thickened myometrium. The surface of the endometrium was smooth. On histological examination, mucinous carcinoma invaded almost the entire myometrium. Adenomyotic lesions were distributed focally in the uterine wall, and transition from adenomyotic glandular epithelium to mucinous carcinoma was detected within several foci. Although adenocarcinoma cells proliferated adjacent to the endometrium, the primary endometrial epithelium was atrophic without atypia. Throughout the myometrium, the mucinous carcinoma cells proliferated and floated in dilated lymph vessels with abundant mucin pools. We diagnosed this case as mucinous carcinoma originating from adenomyosis. Although the patient received 11 courses of intravenous adjuvant chemotherapy, she died of disease 18 months after the first operation. Conclusion As only one case of mucinous carcinoma originating from adenomyosis has been reported to date, this is the second case report of mucinous carcinoma. Moreover, an abnormal manner of proliferation with marked lymphatic permeation of the tumor cells throughout the myometrium was observed.
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spelling doaj.art-46e5a687e4d140be9643cf305d299ed92023-02-12T12:13:22ZengBMCJournal of Medical Case Reports1752-19472023-02-011711510.1186/s13256-023-03772-wMucinous carcinoma originating from uterine adenomyosis: a case reportSatoshi Ohira0Ryota Tachibana1Sayaka Yasaki2Koji Tsunemi3Natsuki Uchiyama4Eri Ikeda5Kenji Sano6Department of Obstetrics and Gynecology, Iida Municipal HospitalDepartment of Obstetrics and Gynecology, Iida Municipal HospitalDepartment of Obstetrics and Gynecology, Iida Municipal HospitalDepartment of Obstetrics and Gynecology, Iida Municipal HospitalDepartment of Obstetrics and Gynecology, Iida Municipal HospitalDepartment of Obstetrics and Gynecology, Iida Municipal HospitalDepartment of Pathology, Iida Municipal HospitalAbstract Background Uterine adenomyosis is rarely a precursor of malignant tumors, but the most frequent histological subtype is endometrioid carcinoma. We observed a rare case of mucinous carcinoma originating from uterine adenomyosis. Case presentation A 63-year-old Japanese woman presented to our hospital with lower abdominal pain. She had no atypical genital bleeding. Ultrasound demonstrated thickening of the entire uterine wall, but the endometrium was not thick. Magnetic resonance imaging demonstrated an enlarged uterus with thickening of the entire uterine wall, suggesting adenomyosis. On the basis of the specimen of endocervical curettage, adenocarcinoma originating from the endometrium was suspected. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed to confirm the diagnosis. Macroscopically, the resected enlarged uterus had no nodules and exudation of mucin was observed from the cut surface of the thickened myometrium. The surface of the endometrium was smooth. On histological examination, mucinous carcinoma invaded almost the entire myometrium. Adenomyotic lesions were distributed focally in the uterine wall, and transition from adenomyotic glandular epithelium to mucinous carcinoma was detected within several foci. Although adenocarcinoma cells proliferated adjacent to the endometrium, the primary endometrial epithelium was atrophic without atypia. Throughout the myometrium, the mucinous carcinoma cells proliferated and floated in dilated lymph vessels with abundant mucin pools. We diagnosed this case as mucinous carcinoma originating from adenomyosis. Although the patient received 11 courses of intravenous adjuvant chemotherapy, she died of disease 18 months after the first operation. Conclusion As only one case of mucinous carcinoma originating from adenomyosis has been reported to date, this is the second case report of mucinous carcinoma. Moreover, an abnormal manner of proliferation with marked lymphatic permeation of the tumor cells throughout the myometrium was observed.https://doi.org/10.1186/s13256-023-03772-wMucinous carcinomaAdenomyosisCase report
spellingShingle Satoshi Ohira
Ryota Tachibana
Sayaka Yasaki
Koji Tsunemi
Natsuki Uchiyama
Eri Ikeda
Kenji Sano
Mucinous carcinoma originating from uterine adenomyosis: a case report
Journal of Medical Case Reports
Mucinous carcinoma
Adenomyosis
Case report
title Mucinous carcinoma originating from uterine adenomyosis: a case report
title_full Mucinous carcinoma originating from uterine adenomyosis: a case report
title_fullStr Mucinous carcinoma originating from uterine adenomyosis: a case report
title_full_unstemmed Mucinous carcinoma originating from uterine adenomyosis: a case report
title_short Mucinous carcinoma originating from uterine adenomyosis: a case report
title_sort mucinous carcinoma originating from uterine adenomyosis a case report
topic Mucinous carcinoma
Adenomyosis
Case report
url https://doi.org/10.1186/s13256-023-03772-w
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