Clear
cell carcinoma (CCC) of the uterine cervix is rare, and its etiology is
unclear, except for reports of prenatal diethylstilbestrol (DES) exposure. In
this case report of a 78-year-old postmenopausal Japanese woman with pelvic
endometriosis, cervical CCC presented as a deep interstitial tumor, strongly
suggesting the patient suffered from cervical endometriosis for a long time. A cystic lesion without solid components was detected
in the uterine cervix. Although the patient had regular gynecological examinations
every 6 months, she presented 5 years later with a complaint of watery vaginal
discharge. Ultrasonography and magnetic
resonance imaging (MRI) detected a uterine cervical cystic mass with a
solid component. Although no malignancy was confirmed preoperatively, surgery
was performed under a high suspicion of cervical cancer. Intraoperative
pathology revealed CCC in a solid tumor, so debulking surgery, including
lymphadenectomy, was done. Endometrial tissue was found adjacent to the tumor,
strongly suggesting the tumor arose from cervical endometriosis. Because
endometriosis in ectopic sites carries a risk of carcinogenesis, as is the case in ovarian endometriosis, it may be recommended
that a cervical cystic lesion with pelvic endometriosis should be followed up
regularly for the early detection of uterine cancer.
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