Gastric-type cervical adenocarcinoma with squamous differentiation: buried in adenosquamous carcinomas?

Virchows Arch. 2021 Aug;479(2):407-412. doi: 10.1007/s00428-020-02997-0. Epub 2021 Jan 6.

Abstract

Gastric-type adenocarcinoma (GAS) of the cervix is a human papilloma virus (HPV)-independent, aggressive, and chemo-resistant adenocarcinoma. However, although the histopathological features of GAS have been extensively investigated, squamous differentiation has not been mentioned. This study aimed to elucidate the frequency of GAS with squamous differentiation and describe their clinicopathological characteristics. We retrospectively evaluated 78 patients with GAS (n = 13) and adenosquamous carcinoma (n = 65) diagnosed between 2000 and 2020. Two patients with GAS with squamous differentiation were identified. Both tumors showed advanced stage (pT2bN1) and had predominant GAS and merged squamous cell carcinoma components without p16-block positivity and HPV DNA. Gastric-type adenocarcinoma in situ was confirmed in both cases. Some cases of GAS could show squamous differentiation mimicking the usual, HPV-associated, adenosquamous carcinoma. GAS with squamous differentiation is recognized as an HPV-independent cancer.

Keywords: Adenosquamous carcinoma; Cervical cancer; Gastric-type adenocarcinoma; HPV-independent cancer; Squamous differentiation.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma in Situ / pathology*
  • Adult
  • Carcinoma, Adenosquamous / pathology*
  • Carcinoma, Squamous Cell / pathology*
  • Cell Differentiation*
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Retrospective Studies
  • Uterine Cervical Neoplasms / pathology*