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Positive endometrial cytology associated with primary gastric adenocarcinomas: Clinical and cytopathologic findings in 16 patients

, : Positive endometrial cytology associated with primary gastric adenocarcinomas: Clinical and cytopathologic findings in 16 patients. International Journal of Clinical Oncology 5(4): 229-235, August

Background: Routine endometrial cytology occasionally includes malignant cells of extra-genital origin. We carried out this study to examine both the clinical and the cytopathologic characteristics of patients with positive endometrial cytology associated with gastric cancer. Methods: Sixteen patients whose endometrial smears contained malignant cells derived from gastric adenocarcinoma were studied. The patients' clinical symptoms, clinical courses, and cytologic and pathological findings were analyzed. Results: Among the 16 patients, 5 showed positive endometrial cytology prior to the initial treatment of gastric cancer, but after its diagnosis; 8 patients were being examined for relapse of gastric cancer; and, in the remaining 3 patients, the endometrial cytology led to the diagnosis of gastric cancer. Eleven patients had some clinical signs or symptoms, including abnormal vaginal discharge. Two patients were positive for serum carcinoembryonic antigen (CEA), while carbohydrate antigen (CA)125 was positive in 5 patients. The histological types of the primary gastric lesions were poorly differentiated adenocarcinoma (including signet ring cell adenocarcinoma) in 14 patients, and moderately differentiated tubular adenocarcinoma in 2 patients. Signet ring cells were observed on endometrial cytology in 12 patients. Four patients showed tumor diathesis on the smears. Metastatic lesions in the uterus were histologically confirmed in 5 patients. All 16 patients died as a result of peritoneal carcinomatosis within 12 months of the positive endometrial smears. Conclusion: Examination of routine reproductive tract smears, especially endometrial cytology, presents gynecologists with the opportunity to identify patients with gastric adenocarcinoma cells in the uterus and/or peritoneal cavity.


DOI: 10.1007/pl00012042

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