Metastatic Carcinoma of the Uterine Cervix from Rectal Carcinoma: A Case Report and Review of the Literature

Primary adenocarcinomas of the uterine cervix account for 5% - 15% of all cervical malignancies, but secondary adenocarcinomas from extragenital cancers are rare. Only 35 cases have been reported in the literature since 1941. We report a 52-year-old Japanese woman who had been treated for rectal adenocarcinoma (Dukes C, stage IIIb) and who was diagnosed with primary uterine cervical carcinoma (FIGO stage Ib2) two years later. A radical hysterectomy was performed and the surgical specimen showed metastatic adenocarcinoma of the uterine cervix from rectal cancer without direct extension. Immunohistochemical staining was positive for cytokeratin 20 and CDX2, and negative for cytokeratin 7. Immunohistochemical staining is important for distinguishing between primary and secondary adenocarcinomas of the cervix, but histologic findings alone are not always adequate to establish the site of the primary lesion. The distinction between primary and secondary adenocarcinomas of the cervix is important for patient management and prognosis. Therefore, the possibility of metastatic adenocarcinoma should be considered whenever a diagnosis of adenocarcinoma of the cervix is received.