Gastric-type endocervical adenocarcinoma: Review of clinicopathologic characteristics and recent advances

Michelle Lin, Kyu-Rae Kim and Jae Ro*

Background: Gastric-type endocervical adenocarcinoma (ECAC) represents a unique variant of endocervical adenocarcinoma that is distinguished by lack of HPV association and an aggressive clinical course with unfavorable prognosis. In this review, we will discuss the clinical and pathologic aspects of gastric-type ECAC, as well as recently described molecular alterations which may be harnessed in future diagnostic and therapeutic strategies.

Results: Clinically, gastric-type ECAC tends to present at an advanced stage with higher rates of extrauterine spread and distant metastasis. Microscopically, gastric-type ECAC is characteristically composed of cells with abundant clear to eosinophilic vacuolated cytoplasm with distinct cell borders, and may demonstrate deceptively benign-appearing morphology. The prognosis of gastric-type ECAC is poor compared to other subtypes of ECAC, as it tends to present with advanced disease and show resistance to conventional chemoradiation therapy. Recent studies have reported a range of molecular alterations in gastric-type ECAC which may have implications in future treatment, including CDKN2A, BRCA2, ERBB2, PIK3CA, ARID1A, and NTRK1/NTRK3 mutations.

Conclusions: Gastric-type ECAC is a relatively recently defined subtype of ECAC with an array of clinical and pathological characteristics that distinguish it from other subtypes of ECAC. As this entity continues to pose difficulties in diagnosis and treatment for pathologists and clinicians alike, continued future investigation is crucial to further our understanding and optimize management of this disease.

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Published on: Oct 8, 2020 Pages: 72-75

Full Text PDF Full Text HTML DOI: 10.17352/jgro.000091
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