Clinicopathologic Features of Gynecologic Malignancies Presenting Clinically as Colonic Malignancies

Abstract Objectives To systematically evaluate gynecologic malignancies (adnexal or uterine) causing gastrointestinal (GI) signs (eg, mass on colonoscopy) or symptoms (eg, bloody stools) clinically mimicking a GI primary malignancy. Methods The archives of 2 institutions were retrospectively reviewe...

Full description

Saved in:
Bibliographic Details
Published in:American journal of clinical pathology 2022-01, Vol.157 (1), p.82-89
Main Authors: Fuller, Lanisha D, Dunn, Andrew, Huber, Aaron R, Vyas, Monika, Gonzalez, Raul S
Format: Article
Language:English
Subjects:
Biopsy
Cancer
Carcinoma
Colon
Colonic Neoplasms - diagnosis
Colonoscopy
Colorectal cancer
Cystadenocarcinoma, Serous
Dysplasia
Female
Genital Neoplasms, Female - diagnosis
Humans
Malignancy
Mimicry
Mucosa
Necrosis
Patients
Retrospective Studies
Uterus
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Objectives To systematically evaluate gynecologic malignancies (adnexal or uterine) causing gastrointestinal (GI) signs (eg, mass on colonoscopy) or symptoms (eg, bloody stools) clinically mimicking a GI primary malignancy. Methods The archives of 2 institutions were retrospectively reviewed for gynecologic malignancies clinically manifesting as colonic lesions. For each case, available radiologic, endoscopic, and histologic findings were recorded. Results We identified 16 cases: 13 biopsies and 3 resections. The masses were localized in the rectosigmoid (14 cases [88%]), right (1 case [6%]), and transverse (1 case [6%]) colon. Gastrointestinal-type complaints included abdominal pain, weight loss, hematochezia, and obstruction; 1 case was asymptomatic and found during screening colonoscopy. Nine patients (56%) had no known prior gynecologic malignancy, and in only 2 of these patients was there some clinical suspicion of a noncolonic primary malignancy. Most cases (13 [81%]) were serous carcinoma, usually high-grade adnexal or primary peritoneal. Six cases (38%) directly extended into the colon, and 7 (44%) metastasized; route of spread was unclear in the others. Only 1 case (6%) showed mucosal involvement, and none showed desmoplasia or dirty necrosis. Four of the 13 serous carcinomas (31%) showed psammoma bodies. Conclusions Advanced gynecologic malignancies, most commonly serous carcinoma, can rarely manifest as GI lesions. Clues to noncolonic origin on biopsy include lack of colonic mucosal involvement/dysplasia, desmoplasia, or dirty necrosis.
ISSN:0002-9173
1943-7722
DOI:10.1093/ajcp/aqab097