Endometrioid adenocarcinoma in an extrauterine adenomyoma.

BACKGROUND: Focal involvement by endometrioid adenocarcinoma in an extrauterine adenomyoma in a patient with stage 1 endometrioid adenocarcinoma presented a unique problem in staging and management of extrauterine endometrial cancer. CASE: A 49-year-old white woman, gravida 0, referred for endometrioid adenocarcinoma was found to have an extrauterine adenomyoma involved with endometrioid adenocarcinoma in the inguinal canal after surgical staging. The endometrioid adenocarcinoma involving the extrauterine adenomyoma was low-grade and noninvasive, representing an embryological anomaly transformed into endometrioid adenocarcinoma by unopposed estrogen. Stage 1A, grade 2 endometrioid adenocarcinoma was diagnosed and observed. CONCLUSION: Stage 1 endometrioid adenocarcinoma with concurrent, noninvasive, focal involvement in an extrauterine adenomyoma represents a secondary site and does not alter disease stage.

Neuroendocrine carcinoma of the vagina in pregnancy.

BACKGROUND: Neuroendocrine carcinoma of the vagina is extremely rare. Treatment options in pregnancy are complex owing to the aggressive tumor type and poor prognosis. CASE: We report the case of a gravid woman diagnosed with stage IVB neuroendocrine carcinoma of the vagina at 16 weeks of gestation. Disease responded to chemotherapy, and pregnancy was continued until onset of preterm labor at 28 5/7 weeks of gestation, with subsequent delivery of a viable fetus. Despite aggressive treatment with chemoradiation postpartum, the patient died of progressive disease 11 months after initial diagnosis. CONCLUSION: A multidisciplinary team should review treatment options and potential complications with the patient. Because of the tendency toward early tumor dissemination, the optimal treatment for neuroendocrine carcinoma in pregnancy involves systemic chemotherapy.