Small primary adenocarcinoma in adenomyosis with nodal metastasis: a case report

Giacomo Puppa, Makio Shozu, Tiziana Perin, Kazuhito Nomura, Annunziata Gloghini, Elio Campagnutta, E Campagnutta, Vincenzo Canzonieri
BMC cancer · 2007 · vol. 7(1) , pp. 103 · doi:10.1186/1471-2407-7-103 · PMID:17584489 · W2043518421
article OA: gold CC0 ⤵ 16 in-corpus citations
📄 Open PDF View on OpenAlex View on PubMed View at publisher

Abstract

BACKGROUND: Malignant transformation of adenomyosis is a very rare event. Only about 30 cases of this occurrence have been documented till now. CASE PRESENTATION: The patient was a 57-year-old woman with a slightly enlarged uterus, who underwent total hysterectomy and unilateral adnexectomy. On gross inspection, the uterine wall displayed a single nodule measuring 5 cm and several small gelatinous lesions. Microscopic examination revealed a common leiomyoma and multiple adenomyotic foci. A few of these glands were transformed into a moderately differentiated adenocarcinoma. The endometrium was completely examined and tumor free. The carcinoma was, therefore, considered to be an endometrioid adenocarcinoma arising from adenomyosis. Four months later, an ultrasound scan revealed enlarged pelvic lymph nodes: a cytological diagnosis of metastatic adenocarcinoma was made. Immunohistochemical studies showed an enhanced positivity of the tumor site together with the neighbouring adenomyotic foci for estrogen receptors, aromatase, p53 and COX-2 expression when compared to the distant adenomyotic glands and the endometrium. We therefore postulate that the neoplastic transformation of adenomyosis implies an early carcinogenic event involving p53 and COX-2; further tumor growth is sustained by an autocrine-paracrine loop, based on a modulation of hormone receptors as well as aromatase and COX-2 local expression. CONCLUSION: Adenocarcinoma in adenomyosis may be affected by local hormonal influence and, despite its small size, may metastasize.

My notes (saved in your browser only)

Condition tags

adenomyosis

MeSH descriptors

Adenocarcinoma Adenocarcinoma Adenomyoma Endometrial Neoplasms Leiomyoma Neoplasms, Multiple Primary Adenocarcinoma Adenocarcinoma Adenomyoma Adenomyoma Aromatase Aromatase Cell Transformation, Neoplastic Cyclooxygenase 2 Cyclooxygenase 2 Endometrial Neoplasms Female Humans Hysterectomy Immunohistochemistry

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (33)

Cited by (16)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-05-13T22:14:54.534439+00:00
License: CC0 · commercial use OK