Cervix
Carcinoma
Serous papillary adenocarcinoma

Authors: Branko Perunovic, M.D., Ashwyna Sunassee, M.D. (see Authors page)
Editor: Ryan Askeland, M.D.

Revised: 4 November 2017, last major update May 2007

Copyright: (c) 2007-2017, PathologyOutlines.com, Inc.

PubMed Search: Serous papillary adenocarcinoma cervix

Cite this page: Serous papillary adenocarcinoma. PathologyOutlines.com website. http://pathologyoutlines.com/topic/cervixserouspap.html. Accessed November 22nd, 2017.
Definition / general
Epidemiology
  • Bimodal age distribution
    • One peak before age 40 years
    • Second peak after age 65 years
Clinical features
  • Abnormal vaginal bleeding
  • Watery vaginal discharge
  • Metastasizes to pelvic and periaortic lymph nodes
  • Stage 1 tumors have similar outcome as other cervical adenocarcinomas; aggressive behavior if supradiaphragmatic metastases
  • In young women, may be focal component of conventional HPV+ adenocarcinoma
  • In menopausal women, may be drop metastasis from HPV negative endometrial or upper genital tract tumor
Radiology description
Prognostic factors
  • Poor prognostic factors:
    • Age < 65 years
    • Stage > I
    • Tumor size > 2 cm
    • Tumor invasion > 10 mm
    • Presence of lymph node metastases
    • Elevation of serum CA - 125
  • When diagnosed at an advanced stage, may behave aggressively with supradiaphragmatic metastases and a rapidly fatal course
  • The outcome for stage I tumors is similar to that of patients with cervical adenocarcinoma of the usual type (Am J Surg Pathol 1998;22:113)
Case reports
Gross description
  • Variable: polypoid / exophytic cervical mass or ulcerated / indurated cervix
  • May resembles endocervical adenocarcinoma
Microscopic (histologic) description
  • Papillary proliferation of pleomorphic epithelial cells with complex papillary architecture on fibrovascular cores, exhibiting epithelial stratification and tufting
  • Cells have protruding apical cytoplasm, moderate / severe nuclear atypia and nuclear pleomorphism
  • Frequent mitotic activity
  • Intense acute and chronic inflammatory infiltrate within cores of papillae and in areas of stromal invasion
  • Often mixed with another adenocarcinoma, frequently low grade villoglandular
  • Psammoma bodies common
Microscopic (histologic) images

Images hosted on other servers:

H&E and p53

Uterus, not necessarily cervix

Cytology description
  • Hypercellar smears with tumor diathesis, papillae, bulky dense cytoplasm, bare nuclei, cells with large pleomorphic nuclei (Cancer 1997;81:98) and numerous nucleoli (Cytopathology 2005;16:125)
  • Also monolayered sheets of mildly atypical glandular cells with papillary branches
  • Also pseudopapillary fragments, tight balls of cells resembling endometrial glandular cells, squamoid cells, psammoma bodies
  • Marked tumor diathesis with primary disease but not metastatic disease to cervix
Cytology images
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Cervical tumor:
H&E, peritoneal fluid

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Uterine tumor:
peritoneal fluid

Negative stains
Differential diagnosis
  • Extension / metastatic ovarian or uterine tumors
Additional references