Three histologically distinct cancers of the uterine corpus: A case report and review of the literature

Masuyama,Hisashi; Haraga,Junko; Nishida,Takashi; Ogawa,Chikako; Kusumoto,Tomoyuki; Nakamura,Keiichiro; Seki,Noriko; Yanai,Hiroyuki; Hiramatsu,Yuji

doi:10.3892/mco.2016.770

Three histologically distinct cancers of the uterine corpus: A case report and review of the literature

Authors:
- Hisashi Masuyama
- Junko Haraga
- Takashi Nishida
- Chikako Ogawa
- Tomoyuki Kusumoto
- Keiichiro Nakamura
- Noriko Seki
- Hiroyuki Yanai
- Yuji Hiramatsu
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Affiliations: Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700‑8558, Japan, Department of Pathology, Okayama University Hospital, Okayama 700‑8558, Japan
Published online on: February 5, 2016 https://doi.org/10.3892/mco.2016.770
Pages: 563-566

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Abstract

Collision tumors, which are characterized by the coexistence of two or more completely distinct and independent tumors in the uterine corpus, are very rare. A collision tumor is mainly composed of two distinct tumor types, epithelial and mesenchymal. To the best of our knowledge, there has only been a single case in which a choriocarcinoma with an endometrial carcinoma were coexistent but histologically distinct. We herein report the first case of a collision tumor in a 52‑year‑old woman, with a history of two pregnancies and two deliveries. The collision tumor was composed of three histologically distinct neoplasms in the uterine corpus, namely an endometrioid carcinoma, an undifferentiated carcinoma and a choriocarcinoma. The patient underwent hysterectomy, bilateral adnexectomy and pelvic lymph node dissection, followed by six cycles of adjuvant chemotherapy with paclitaxel̸carboplatin due to the high risk of endometrial cancer, and an additional five cycles of chemotherapy with methotrexate, as the β‑human chorionic gonadotropin level was beyond the normal range. Following adjuvant chemotherapy, the tumor markers were within normal limits and no relapses of the cancer have been observed during 1 year of follow‑up. Diagnosing a collision tumor prior to surgery is difficult if the neoplasms are in close proximity, or if one of the tumors predominates. Careful pathological examination is crucial for accurately diagnosing the neoplasms in a collision tumor and ensuring appropriate management and a favorable prognosis.

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1	Kurman RJ, Carcangiu ML, Herrington CS and Young RH: WHO classification of tumours OF female reprOduCTive organs. WHO CLASSIFICATION OF TUMOURS. 6:(4TH). (Lyon). IARC Press. 122–167. 2014.
2	Stewart BW and Wild CP: World Cancer Report 2014. Chapter 5.12. LYON: IARC PRESS. 2014.
3	Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw KD and Cunningham FG: Endometrial cancer. Williams Gynecology. Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw KD and Cunningham FG: (2ND). (New York). McGraw-Hill. 817–838. 2012.
4	Lurain JR: Gestational trophoblastic disease II: Classification and management of gestational trophoblastic neoplasia. Am J Obstet Gynecol. 204:11–18. 2011. View Article : Google Scholar : PubMed/NCBI
5	Chittenden B, Ahamed E and Maheshwari A: Choriocarcinoma in a postmenopausal woman. Obstet Gynecol. 114:462–465. 2009. View Article : Google Scholar : PubMed/NCBI
6	Russell P and Farnsworth A: Non-gestational choriocarcinomas. Surgical Pathology of the Ovaries. Russell P and Farnsworth A: (2ND). (Edinburgh). Churchill Livingstone. 263–264. 1997.
7	Jiao LZ, Xiang Y, Feng FZ, Wan XR, Zhao J, Cui QC and Yang XY: Clinical analysis of 21 cases of nongestational ovarian choriocarcinoma. Int J Gynecol Cancer. 20:299–302. 2010. View Article : Google Scholar : PubMed/NCBI
8	Haruma T, Ogawa C, Nishida T, Kusumoto T, Nakamura K, Seki N, Katayama T and Hiramatsu Y: Pure choriocarcinoma of the ovary in Silver-Russell syndrome. Acta Med Okayama. 69:183–188. 2015.PubMed/NCBI
9	Ishida M and Okabe H: Endometrioid adenocarcinoma with choriocarcinomatous differentiation: A case report and review of the literature. Oncol Lett. 6:655–658. 2013.PubMed/NCBI
10	Gao HJ, Zhou W, Zhang XF, Zhou CY and Qian JH: Coexistent gestational choriocarcinoma and mixed adenocarcinoma of the uterus. Eur J Gynaecol Oncol. 34:362–367. 2013.PubMed/NCBI
11	Van Eeden S, Nederlof PM, Taal BG, Offerhaus GJ and Van Velthuysen ML: A tumour with a neuroendocrine and papillary serous component: Two or a pair? J Clin Pathol. 55:710–714. 2002. View Article : Google Scholar : PubMed/NCBI
12	Singh AK and Singh M: Collision tumours of ovary: A very rare case series. J Clin Diagn Res. 8:FD14–FD16. 2014.PubMed/NCBI
13	Patwardhan JR and Gadgil RK: Collision tumour of the uterus. Indian J Cancer. 6:194–197. 1969.PubMed/NCBI
14	Lifschitz-Mercer B, Czernobilsky B, Dgani R, Dallenbach-Hellweg G, Moll R and Franke WW: Immunocytochemical study of an endometrial diffuse clear cell stromal sarcoma and other endometrial stromal sarcomas. Cancer. 59:1494–1499. 1987. View Article : Google Scholar : PubMed/NCBI
15	Sreenan JJ and Hart WR: Carcinosarcomas of the female genital tract. A pathologic study of 29 metastatic tumors: Further evidence for the dominant role of the epithelial component and the conversion theory of histogenesis. Am J Surg Pathol. 19:666–674. 1995. View Article : Google Scholar : PubMed/NCBI
16	Lam KY, Khoo US and Cheung A: Collision of endometrioid carcinoma and stromal sarcoma of the uterus: A report of two cases. Int J Gynecol Pathol. 18:77–81. 1999. View Article : Google Scholar : PubMed/NCBI
17	Gaertner EM, Farley JH, Taylor RR and Silver SA: Collision of uterine rhabdoid tumor and endometrioid adenocarcinoma: A case report and review of the literature. Int J Gynecol Pathol. 18:396–401. 1999. View Article : Google Scholar : PubMed/NCBI
18	Takahashi Y and Inoue T: Hepatoid carcinoma of the uterus that collided with carcinosarcoma. Pathol Int. 53:323–326. 2003. View Article : Google Scholar : PubMed/NCBI
19	Shaco-Levy R, Manor E, Piura B and Ariel I: An unusual composite endometrial tumor combining papillary serous carcinoma and small cell carcinoma. Am J Surg Pathol. 28:1103–1106. 2004. View Article : Google Scholar : PubMed/NCBI
20	Jang KS, Lee WM, Kim YJ and Cho SH: Collision of three histologically distinct endometrial cancers of the uterus. J Korean Med Sci. 27:89–92. 2012. View Article : Google Scholar : PubMed/NCBI
21	Zhao J, Xiang Y, Wan XR, Feng FZ, Cui QC and Yang XY: Molecular genetic analyses of choriocarcinoma. Placenta. 30:816–820. 2009. View Article : Google Scholar : PubMed/NCBI
22	Wang Y, Yang Y, Teng F, Zhang H and Xue F: Pure nongestational uterine choriocarcinoma in a postmenopausal Chinese woman confirmed with short tandem repeat analysis. Am J Obstet Gynecol. 211:e1–e3. 2014. View Article : Google Scholar
23	Hirata Y, Yanaihara N, Yanagida S, Fukui K, Iwadate K, Kiyokawa T and Tanaka T: Molecular genetic analysis of nongestational choriocarcinoma in a postmenopausal woman: A case report and literature review. Int J Gynecol Pathol. 31:364–368. 2012. View Article : Google Scholar : PubMed/NCBI
24	Fisher RA, Newlands ES, Jeffreys AJ, Boxer GM, Begent RH, Rustin GJ and Bagshawe KD: Gestational and nongestational trophoblastic tumors distinguished by DNA analysis. Cancer. 69:839–845. 1992. View Article : Google Scholar : PubMed/NCBI
25	Fisher RA, Savage PM, MacDermott C, Hook J, Sebire NJ, Lindsay I and Seckl MJ: The impact of molecular genetic diagnosis on the management of women with hCG-producing malignancies. Gynecol Oncol. 107:413–419. 2007. View Article : Google Scholar : PubMed/NCBI
26	Johnson N, Bryant A, Miles T, Hogberg T and Cornes P: Adjuvant chemotherapy for endometrial cancer after hysterectomy. Cochrane Database Syst Rev: CD003175. 2011. View Article : Google Scholar