Invasive breast carcinoma - IARC

endometrioid adenocarcinoma of the
endometrium; however, squamous elements
are less common. Little or no intracellular
mucin is present. A distinction
from an endocervical type adenocarcinoma
is only possible in well differentiated
lesions. This neoplasm must be distinguished
from one extending into the
cervix from the endometrium.
Clear cell adenocarcinoma
An adenocarcinoma that is composed
mainly of clear or hobnail cells arranged
in solid, tubulocystic or papillary patterns
or a combination.
This rare tumour is histologically similar
to clear cell adenocarcinoma of the
ovary, endometrium and vagina, where
they are more common. Although well
known because of its association with in
utero exposure to diethylstilbestrol (DES)
in young women, its peak frequency is at
present in the postmenopausal group.
Genomic instability has been suggested
as a mechanism of DES-related carcinogenesis
{330}.
A
Serous adenocarcinoma
A complex pattern of papillae with cellular
budding and the frequent presence of
psammoma bodies characterize serous
adenocarcinoma. Before a diagnosis of
primary serous adenocarcinoma of the
cervix can be made, spread from the
endometrium, ovaries or peritoneum
should be excluded. These rare cervical
tumours are histologically identical to
their ovarian counterparts {565}. A single
case was familial. The patient, identical
twin sister and mother all had serous
tumours of the genital tract {1398}.
B
Mesonephric adenocarcinoma
C
Fig. 5.23 Mesonephric adenocarcinoma. A In some areas of the tumour, the proliferation of tubules resembles
the diffuse pattern of mesonephric hyperplasia with intraluminal colloid-like secretions. B Other areas contain
a more complex growth pattern with early formation of papillary structures (same case as in A). C The tubules
exhibit nuclear atypia and mitotic figures.
These adenocarcinomas arise fro m
mesonephric remnants and are most
often located in the lateral to posterior
wall of the cervix but may involve the
cervix circumferentially. Among the 20
reported examples, the patients ranged
in age from 33-74 years with a median
age of about 52 years. Whereas they
often present as exophytic lesions, they
may remain completely intramural simply
expanding the cervical wall. Histologically,
they are commonly characterized
by tubular glands lined by mucin-free
cuboidal epithelium containing eosinophilic,
hyaline secretion in their lumens in
its well diff e rentiated areas or larger
glands showing endometrioid differentiation
{521}, but other patterns including
solid, papillary, ductal and a retiform
arrangement may develop. A vast majority
arise in a background of mesonephric
remnant hyperplasia {850,2036,2679}.
274 Tumours of the uterine cervix