Co-existing adenoid cystic carcinoma and invasive squamous cell carcinoma of the uterine cervix: a rare case report and literature review

Adenoid cystic carcinoma (ACC) is a rare cervical malignancy, and its coexistence with other malignancies in the uterine cervix is extremely rare. Here, we present a case of coexistence of ACC and invasive squamous cell carcinoma (SCC) of the uterine cervix, as well as a literature review. A 68-year-old Chinese woman with vaginal bleeding underwent a cervical cytology screening, cervical biopsy, and finally cervical conization. Subsequent pathological diagnoses of coexisting ACC and invasive SCC were rendered with a positive margin. Her status post-radiation therapy showed no recurrence or metastasis after a follow-up of 7 months. Immunohistochemical studies of the surgical specimen revealed that the ACC component exhibited a pattern distinct from the SCC component. ACC was collagen IV, S-100 and CK7 positive, and p63 and CK34βE12 (CK903) patchy positive; SCC was p63 and CK34βE12 (CK903) strongly and diffusely positive, while negative for collagen IV, S-100, and CK7. Both components were positive for high-risk human papilloma virus types 16 and 18, detected by in situ hybridization. This case is among very few previously described cases of coexisting ACC with invasive SCC in the uterine cervix.