Invasive stratified mucin-producing carcinoma (i-SMILE) of the uterine cervix: report of a case series and review of the literature indicating poor prognostic subtype of cervical adenocarcinoma.

Autor: Horn LC; Division of Gynecologic, Breast and Perinatal Pathology, Institute of Pathology, University Hospital Leipzig, Liebigstrasse 26, 04103, Leipzig, Germany. hornl@medizin.uni-leipzig.de., Handzel R; Division of Gynecologic Oncologic Surgery, Department of Obstetrics and Gynecology (Institute of Trier), University Hospital Leipzig, Leipzig, Germany., Borte G; Department of Diagnostic Radiology, University Hospital Leipzig, Leipzig, Germany., Siebolts U; Division of Molecular Pathology, Institute of Pathology, University Hospital Halle/Saale, Halle/saale, Germany., Haak A; Division of Molecular Pathology, Institute of Pathology, University Hospital Halle/Saale, Halle/saale, Germany., Brambs CE; Department of Obstetrics and Gynecology, Technical University Munich, Munich, Germany.
Jazyk: angličtina
Zdroj: Journal of cancer research and clinical oncology [J Cancer Res Clin Oncol] 2019 Oct; Vol. 145 (10), pp. 2573-2582. Date of Electronic Publication: 2019 Aug 05.
DOI: 10.1007/s00432-019-02991-3
Abstrakt: Purpose: Invasive stratified mucin-producing carcinoma (i-SMILE) represents a recently recognized subtype of cervical adenocarcinoma (AC) developing in a background of a stratified mucin-producing intraepithelial lesion (SMILE). Clinical and prognostic data on i-SMILE are limited.
Methods: We report a series of five cases with histopathological, immunohistochemical (p16) and PCR analyses. The cases as well as the patients previously published in the literature were reviewed for follow-up information.
Results: Thirteen cases were identified. The mean age of 47.1 years (range 34-66) was not different from the usual type of cervical AC. 10/13 cases presented with tumors > 2 cm and a polypoid-exophytic appearance. Regardless of tumor size and stage of the disease, 7 out of 11 patients developed recurrent disease after a mean of 7.8 months (range 6 weeks-36 months). Five patients developed distant metastases (three of them in the lungs). Five out of the 11 informative cases died of the disease. All reported cases were positive for high-risk HPV (mainly HPV type 18) and associated with p16-overexpression.
Conclusion: i-SMILE represent a distinct subtype of invasive endocervical AC, associated high-risk HPV infection and strong p16-overexpression. Clinically, i-SMILE may represent an aggressive tumor with early recurrent disease and substantial risk of distant metastatic disease, especially to the lungs.
Databáze: MEDLINE
Externí odkaz: