NONPRIMARY CERVICAL ADENOCARCINOMAS

We reviewed 16 non-primary cervical adenocarcinomas collected during a six year period. Ten tumors originated in the endometrium, three in t he ovary and one each in the bladder, colon and fallopian tube. Tumor spread was identified by combined lymphovascular involvement and strom al invasion in five of the 16 cervices, lymphovascular involvement alo ne in four cervices, stromal invasion alone in two cervices, lymphovas cular involvement with stromal invasion and cervical implantation in t wo cervices and cervical implantation atone in three cervices. The thr ee tumors with surface implantation alone were of endometrial origin, had minimal if any myometrial invasion, no extrauterine metastases and two had malignant peritoneal washings. Of the 13 tumors with cervical lymphovascular involvement and/or stromal metastases, 11 had ovarian, nodal and/or peritoneal metastases. We conclude that cervical implant ation occurs exclusively with endometrial adenocarcinomas, that it fol lows previous cervical instrumentation and that the prognosis is depen dent on the histoprognostic features of the primary endometrial tumor. In contrast, cervical lymphovascular involvement and/or stromal metas tases usually reflects disseminated pelvic or abdominal malignancy wit h a poor prognosis. However histological examination may not afford se paration of these two lesions if local cervical invasion is advanced, if spread has occurred by more than one mode or if insufficient clinic al/surgical information is provided.