A rare case of gastric-type mucinous endocervical adenocarcinoma in a 59-year-old woman

Introduction
Endocervical adenocarcinoma represents 20-25% of the histological types of cervical carcinoma. Gastric-type mucinous adenocarcinoma of the cervix is a rare type of cancer with aggressive behavior. This type of malignancy is not related to high-risk human papillomavirus (HPV).

Case report
We report a 59-year-old postmenopausal woman complaining of vaginal bleeding and pelvic pain. Histological analysis of punch biopsy and endocervical curettage revealed possible endocervical mucinous adenocarcinoma, while magnetic resonance imaging (MRI) revealed a 10 × 8 cm sized cervical mass. According to oncologists, the tumor was inoperable, so the patient received 6 cycles of chemotherapeutic agents with carboplatin, paclitaxel and bevacizumab from December 2019 to March 2020. However, chemotherapy had very poor results in this patient, because the mass was increased to 24 cm in a new MRI performed after the end of chemotherapy. Finally, the patient underwent radical surgery. On histopathological examination, the surgical margin was all free from everywhere and the mass was confirmed as a gastric-type mucinous adenocarcinoma of the cervix with low differentiation.

Conclusions
It is very important to have an early diagnosis of gastric-type mucinous adenocarcinoma of the cervix, as this tumor is poorly symptomatic and very aggressive. When chemotherapy is not effective, radical surgery may be a solution for better survival.