A case of rectal adenocarcinoma found in endocervical cytology

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Background: We report a case of rectal adenocarcinoma found in endocervical cytology. We compared colorectal adenocarcinoma, endometrial adenocarcinoma and endocervical adenocarcinoma using immunohistochemistry. Case: A 78-year-old woman with atypical bleeding since 2 to 3 years before noted atypical genital bleeding and was found to have serve anemia and a 4×3cm endocervical cancer tumor was found in the endocervix. Endocervical adenocarcinoma was diagnosed by biopsy and cytology. Colorectal examination found rectal cancer. The rectal tumor was type 2 and 6×5.3cm, in size, infiltrating into the cervix and the vaginal posterior to the anterior wall. A polypoid tumor filling the cavity of the corpus uteri was thought to be metastatic from the rectum. Conclusion: Immunohistochemically, colorectal adenocarcinoma cells were positive for cytokeratin 20 and carcinoembryonic antigen, however, endometrial and endocervical adenocarcinoma cells were positive for cytokeratin 7, CA125, estrogen receptor, and progesterone receptor. This case is similar to those for colorectal adenocarcinoma. Immunohistochemistry is useful for differentiating colorectal adenocarcinoma from endometrial and endocervical adenocarcinoma. Rectal adenocarcinoma cells may be found in cytology. It is difficult to determinel the primary site, if tumor cells cytology is atypical, requiring careful observation in cytology.
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