Table 1 Histologic type, HPV status, and clinical profiles of cervical carcinomas with serous-like features.
Case | Histologic type | HPV status | Age (years) | Clinical presentation | Size (cm) | Location | FIGO (2018) stage | Primary treatment | Clinical outcome |
|---|---|---|---|---|---|---|---|---|---|
HPV-associated cervical carcinomas with serous-like features (cases 1–10) | |||||||||
1 | Usual endocervical adenocarcinoma | HPV 16 | 52 | Menorrhagia and anemia | 3 × 2 | Posterior lip of cervix | IB2 | Radical hysterectomy, BSO and PLND | NED at 18 years (vaginal vault recurrence at 3 years after operation, treated with chemotherapy and radiotherapy) |
2 | Usual endocervical adenocarcinoma | HPV 18 | 46 | Menorrhagia and anemia | 7 × 6.4 × 6.3 (by imaging) | Posterior lip of cervix | IIIC2 | RT | DOD at 4 months (pelvic and para-aortic lymph node metastasis) |
3 | Usual endocervical adenocarcinoma | HPV 16 | 62 | Postmenopausal bleeding | 3 | Anterior lip of cervix and vaginal fornix | IIA1 | Radical hysterectomy and PLND | NED at 14 years (vaginal vault recurrence 1 year after operation, treated with chemotherapy and radiotherapy) |
4 | Usual endocervical adenocarcinoma | HPV 18 | 58 | Postmenopausal bleeding | 2 | Anterior lip of cervix | IB1 | Radical hysterectomy, BSO and PLND; adjuvant RT | Alive with disease at 7 years (lung metastasis) |
5 | Usual endocervical adenocarcinoma | HPV 16 | 46 | Asymptomatic (abnormal cervical smear on routine screening) | No gross lesions (8 mm by microscopy) | NA | IA | Total hysterectomy and BSO | NED at 7 years |
6 | Usual endocervical adenocarcinoma | HPV 18 | 53 | Irregular menses and passage of tissue mass | 7 | Entire cervix and anterior vagina (down to the lower one-third) | IVA | Chemo-irradiation | DOD after 2 years (invasion of the bladder, left common iliac and para-aortic lymph node, peritoneal, and liver metastasis) |
7 | Usual endocervical adenocarcinoma | HPV 16 | 52 | Postmenopausal bleeding | 4 × 2.9 × 2.2 (by imaging) | Entire cervix | IB2 | Radical hysterectomy, BSO, and PLND | NED at 7 years |
8 | Usual endocervical adenocarcinoma | NA | 34 | Postcoital bleeding | 3 | Entire cervix (predominantly anterior lip) | IB2 | Radical hysterectomy and PLND | NED at 7 years |
9 | Adenosquamous carcinoma | HPV 18 | 43 | Menorrhagia and anemia | 7 × 6 | Entire cervix | IIIC2 | Radical hysterectomy, BSO, omentectomy, PLND and para-aortic lymph node dissection; adjuvant chemotherapy | NED at 2 years |
10 | Adenosquamous carcinoma | HPV 18 | 37 | Asymptomatic (abnormal cervical smear on routine screening) | No gross lesions (at least 12 mm by microscopy) | NA | IIIC2 (based on imaging evidence of pelvic and para-aortic lymph node metastasis) | Loop electrosurgical excision procedure; chemo-irradiation planned | NA (recent case) |
HPV-independent cervical carcinomas with serous-like features (cases 11–14) | |||||||||
11 | Gastric-type adenocarcinoma | – | 66 | Postmenopausal bleeding and lower abdominal pain | 5.7 × 4.9 × 4.3 (by imaging) | Anterior lip of cervix | IIIC1 | Chemo-irradiation (BSO performed for benign cyst) | DOD at 20 months (pelvic, inguinal, and supraclavicular lymph node metastasis) |
12 | Gastric-type adenocarcinoma | NA | 45 | NA | 1.6 | NA | IB1 | Total hysterectomy and BSO; adjuvant RT | DOD at 4 years (pelvic soft tissue, para-aortic lymph node, and lung metastasis) |
13 | Gastric-type adenocarcinoma | – | 68 | Postmenopausal bleeding | 3.5 | Entire cervix and lower uterine segment | IIIC1 | Radical hysterectomy, BSO, and PLND; adjuvant RT | DOD after 12 months (vaginal vault recurrence and invasion of the rectum) |
14 | Gastric-type adenocarcinoma | – | 86 | Postmenopausal bleeding | 3.1 × 1.8 × 1.7 (by imaging) | Entire cervix | IB2 | Radical RT | NED at 2 years |
