Adenoid Cystic Carcinoma of Cervix: A Rare Entity

Adenoid cystic carcinoma is a malignant neoplasm rarely occurring in the uterine cervix. It accounts for less than 1% of all cervical carcinomas.

Herein we report a case of Adenoid cystic carcinoma of the cervix in a 41-year-old woman who presented with a 3-month history of bleeding and discharge per vaginum.

The patient underwent a biopsy. On histopathological evaluation, the section showed fragments of squamous epithelium with a subepithelial tumor arranged in tubules, anastomosing cords, and sheets. Tumor cells were basaloid with scant cytoplasm and hyperchromatic nucleus. Some of the tubules contained myxoid matrix. The cords were separated by basement membrane like material. On immunohistochemistry, a biphasic tumor was identified composed of luminal epithelial cells highlighted by CK7, CD117, and BerEP4, and the myoepithelial cells highlighted by p63. There was a diffuse nuclear and cytoplasmic expression of the p16 protein. Tumor cells were negative for GATA3, Synaptophysin, Chromogranin, CD56, S100, and PAX8. Based on morphology and immunohistochemistry, a diagnosis of Adenoid cystic carcinoma was considered.

Compared to other cervical malignancies, Adenoid cystic carcinoma is exceedingly rare and has an aggressive clinical course with early nodal and distant metastases. Diagnosis is often tedious owing to the rarity and the histological overlap with other neoplasms. We have discussed this case along with a brief review of Adenoid cystic carcinoma of the cervix.