Synchronous Ovarian Endometrioid Adenocarcinoma and Endocervical Mucinous Adenocarcinoma

Abstract

We report a rare case of synchronous cancer consisting of ovarian endometrioid adenocarcinoma and endocervical mucinous adenocarcinoma. Related literature was reviewed and it appeared that no similar case had been reported previously. A 30-year-old (gravida 1, para 1, abortus 0) woman complained of abdominal fullness, chest tightness and dyspnea on exertion of several days' duration. Gynecologic sonography showed a right complex adnexal cyst, 16 x 14 cm in size. Computed tomography showed an 18 x 16 cm right pelvic tumor, with both cystic and solid components, ascites and bilateral massive pleural effusion. Cytology of the pleural effusion showed no malignant cells. The patient underwent staging surgery. Histology showed moderately to poorly differentiated endometrioid adenocarcinoma of the right ovary with extensive lymphovascular permeation, as well as paraaortic and bilateral pelvic lymph node metastases. Extensive tumor thrombi were observed in the lymphovascular channels of the left ovary, bilateral tubes and uterus. Endocervical adenocarcinoma, < 3 mm in depth, was also identified on the cervix. The final surgical-pathologic stage of ovarian endometrioid adenocarcinoma was stage IIIc and of endocervical mucinous adenocarcinoma was stage IA1. Adjuvant chemotherapy with carboplatin and paclitaxel was prescribed postoperatively, but the malignancy was not controlled due to lung, brain and vulva metastases. The patient died of respiratory failure. The coexistence of primary neoplasms in the ovary and cervix is rare. Diagnosis should be based on histologic examination and requires appropriate treatment for both tumors.