Clinical, morphologic, and molecular features associated with ovarian metastases from pattern a endocervical adenocarcinomas Journal Article
| Authors: | Feinberg, J.; Hodgson, A.; Abu-Rustum, N. R.; Roche, K. L.; Park, K. J. |
| Article Title: | Clinical, morphologic, and molecular features associated with ovarian metastases from pattern a endocervical adenocarcinomas |
| Abstract: | Ovarian metastases from endocervical adenocarcinomas (EAs) are rare but well-described. Silva Pattern A tumors have been reported to pose essentially no risk of lymph node metastases or recurrence. We describe a cohort of patients with Silva Pattern A EAs with ovarian metastases, as well as involvement of other sites. Eight pattern A EAs with ovarian metastases (4 synchronous, 4 metachronous) were identified from our institution's pathologic archives (2008-2021). Clinicopathologic and molecular features for each case were recorded. All patients were treated by hysterectomy; in each case, the entire tumor was submitted for histologic evaluation. The synchronous metastases were all clinically suspected to be ovarian primary tumors; EAs with metachronous ovarian involvement were confined to the uterus at initial diagnosis, with ovarian metastasis occurring 5 to 171 months after hysterectomy. Morphologically, all tumors were predominantly gland-forming, 5/8 (63%) displayed prominent mucinous differentiation, and 5/8 (63%) involved the corpus. All EAs were either noninvasive (exophytic/papillary/more complex than adenocarcinoma in situ) or showed nondestructive cervical stromal invasion to a depth of 5 mm or less. In the 5 tumors tested by next-generation sequencing, ARID1A, GNAS, and KRAS mutations were detected in 2 (40%), 3 (60%), and 4 (80%) cases, respectively. All 6 patients with follow-up (range, 32 to 181 mo; median, 99.5 mo) had at least 1 recurrence. All but one are without evident disease at last clinical assessment. In an otherwise typical Silva Pattern A EA, corpus involvement, mucinous differentiation, and certain gene mutations may be associated with risk for synchronous or metachronous ovarian metastases. |
| Keywords: | tumors; carcinoma; kras; in-situ; preservation; criteria; cervical adenocarcinoma; classification-system; arid1a; cancer; endocervical adenocarcinoma; gnas; ovarian metastases; pattern a |
| Journal Title: | American Journal of Surgical Pathology |
| Volume: | 46 |
| Issue: | 4 |
| ISSN: | 0147-5185 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2022-04-01 |
| Start Page: | 509 |
| End Page: | 518 |
| Language: | English |
| ACCESSION: | WOS:000769634300009 |
| DOI: | 10.1097/pas.0000000000001845 |
| PROVIDER: | wos |
| PMCID: | PMC8930534 |
| PUBMED: | 34889854 |
| Notes: | Article -- Source: Wos |
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786Abu-Rustum -
289Park -
205Long Roche -
15Feinberg -
18Hodgson
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