Clear Cell Carcinoma of the Uterine Cervix Arising from an Interstitial Cyst Complicated with Endometriosis: A Case Report

Abstract

Clear \ncell carcinoma (CCC) of the uterine cervix is rare, and its etiology is \nunclear, except for reports of prenatal diethylstilbestrol (DES) exposure. In \nthis case report of a 78-year-old postmenopausal Japanese woman with pelvic \nendometriosis, cervical CCC presented as a deep interstitial tumor, strongly \nsuggesting the patient suffered from cervical endometriosis for a long time. A cystic lesion without solid components was detected \nin the uterine cervix. Although the patient had regular gynecological examinations \nevery 6 months, she presented 5 years later with a complaint of watery vaginal \ndischarge. Ultrasonography and magnetic \nresonance imaging (MRI) detected a uterine cervical cystic mass with a \nsolid component. Although no malignancy was confirmed preoperatively, surgery \nwas performed under a high suspicion of cervical cancer. Intraoperative \npathology revealed CCC in a solid tumor, so debulking surgery, including \nlymphadenectomy, was done. Endometrial tissue was found adjacent to the tumor, \nstrongly suggesting the tumor arose from cervical endometriosis. Because \nendometriosis in ectopic sites carries a risk of carcinogenesis, as is the case in ovarian endometriosis, it may be recommended \nthat a cervical cystic lesion with pelvic endometriosis should be followed up \nregularly for the early detection of uterine cancer.