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Clear Cell Carcinoma of the Uterine Cervix Presented as a Submucosal Tumor Arising in a Background of Cervical Endometriosis

Hashiguchi, Mariko M.D.; Kai, Keita M.D., Ph.D.; Nishiyama, Satoshi M.D.; Nakao, Yoshifumi M.D., Ph.D.; Yokoyama, Masatoshi M.D., Ph.D.; Aishima, Shinichi M.D., Ph.D.

International Journal of Gynecological Pathology: January 2018 - Volume 37 - Issue 1 - p 88–92
doi: 10.1097/PGP.0000000000000386

Clear cell carcinoma (CCC) of the uterine cervix without prenatal diethylstilbestrol exposure is rare, and its etiology is unclear. We present a case of cervical CCC presenting as a submucosal tumor, which strongly suggests an association between cervical endometriosis and cervical CCC. A 56-year-old postmenopausal Japanese woman visited a gynecologic clinic with a complaint of watery vaginal discharge. A few atypical cells suggesting adenocarcinoma were detected in a cervical cytologic specimen. Magnetic resonance imaging revealed a cystic lesion with a solid component at the uterine cervix. Under a tentative diagnosis of cervical cancer, surgery was performed. Although a freshly resected specimen initially showed no tumorous lesion in the cervical mucosa, cutting of the mucosa revealed a solid tumor with a final diagnosis of CCC. The findings of aggregation of hemosiderin-laden macrophages and ectopic endometrium adjacent to the tumor strongly suggest that this tumor arose from cervical endometriosis.

Departments of Pathology & Microbiology (M.H., S.A.)

Obstetrics & Gynecology (M.H., S.N., Y.N., M.Y.), Saga University Faculty of Medicine

Department of Pathology, Saga University Hospital (K.K., S.A.), Saga, Japan

The authors declare no conflict of interest.

Address correspondence and reprint requests to Keita Kai, MD, PhD, Department of Pathology, Saga University Hospital, Nabeshima 5-1-1, Saga City, Saga 849-8501, Japan. E-mail:

©2018International Society of Gynecological Pathologists