Endometrioid Adenocarcinoma Involving the Endocervix in a Postmenopausal Woman Presenting with Abnormal Uterine Bleeding: A Case Report

Abstract

Endometrioid adenocarcinoma involving the endocervix is uncommon and can present a difficult site-of-origin differential because endometrial endometrioid carcinoma may extend into the cervix and some cervical adenocarcinomas may show endometrioid-like morphology. A 58-year-old postmenopausal woman presented with a three-month history of abnormal uterine bleeding, progressive pelvic discomfort, fatigue, and dizziness. Examination revealed pallor and an irregular, firm endocervical mass. Her haemoglobin concentration was 6.8 g/dL. Pelvic ultrasonography and magnetic resonance imaging demonstrated a 4.2 × 3.8 cm endocervical mass without parametrial involvement, and no distant metastases were detected. Endocervical biopsy showed endometrioid adenocarcinoma. After correction of severe anaemia with blood transfusion and supportive care, the patient underwent radical hysterectomy with bilateral salpingo-oophorectomy and pelvic lymph-node dissection. The resection specimen showed moderately differentiated endometrioid adenocarcinoma involving the cervix with invasion through more than half of the cervical stroma. Surgical margins were negative, and no lymph-node metastases were identified. The immediate postoperative course was uneventful, and the patient was referred for oncology evaluation and subsequent management. Because ancillary HPV-associated testing and a complete immunophenotypic differential were not reported, the tumour is most cautiously described as endometrioid adenocarcinoma involving the endocervix. This case emphasises systematic evaluation of postmenopausal bleeding and careful clinicopathological assessment when an endometrioid adenocarcinoma involves the cervix.