Minimal deviation adenocarcinoma of the cervix and tumorlets of sex-cord stromal tumor with annular tubules of the ovary in Peutz-Jeghers syndrome
A 35-year-old, single, virgin woman was referred to our hospital due to an abnormal finding of a Papanicolaou test, reported to be atypical glandular cells. Her past medical history was unremarkable except for melanin pigments on her digits and lips. Her parents and all of her siblings were alive and had no history of polyps or cancer in the gastrointestinal tract. She had undergone colonoscopic polypectomy at the age of 25 years and was diagnosed with a hamartomatous polyp.\nA physical examination revealed a diffusely firm mass at the whole cervix. Pelvic MRI demonstrated a 4.4×3.3×2.2 cm sized mass at the whole cervix (). The serum levels of CA-125 and CA 19-9 were within normal limits. The preoperative loop electrosurgical excision procedure (LEEP) of cervix was confirmed as minimal deviation adenocarcinoma. She also underwent radical hysterectomy with bilateral salpingooophorectomy and bilateral pelvic node dissection.\nGrossly, a solid and infiltrating tumor mass at the whole cervix measures 4.5×3.0×2.5 cm (). Microscopically, the cervical tumor was diagnosed as MDA () and scattered foci of tumorlets of SCTATs (). Colonoscopic polypectomy confirmed the presence of a hamartomatous polyp ().\nImmunohistochemistry with the rabbit polyclonal antibody to LKB1 (Novus Biologicals) showed nuclear and cytoplasmic expression in atypical endocervical glands (). FIGO of case 2 was IIA due to no tumor invasion of parametrium. She received combined chemo-radiotherapy with 3 cycles of paclitaxel and carboplatin regimen, and has no evidence of tumor recurrence for 5 years. In case 2, the STK11/LKB1 gene mutation was not found.