SYNCHRONOUS ENDOMETRIAL AND ENDOCERVICAL ADENOCARCINOMA

The majority of synchronous multiple primary neoplasms of the female r eproductive tract are of endometrial and ovarian origin. We did not fi nd a description of synchronous endocervical and endometrial adenocarc inoma in our search of the literature. We describe the clinicopatholog ic features of three patients, who presented with post-menopausal blee ding and were found to have separate primary adenocarcinomas of the en docervix and endometrium. Polymerase chain reaction and in situ hybrid ization studies were negative for human papilloma virus DNA sequences. All patients underwent hysterectomy and bilateral salpingooophorectom y and received post-operative radiation therapy. One patient died of h er disease. The other two are alive without evidence of disease. Since the incidence of cervical adenocarcinoma is increasing more such case s will be diagnosed, raising important therapeutic issues. Routine cyt ology cannot reliably predict the exact origin of tumors in the uterus . Biopsies from endometrium and an endocervical curettage may assist i n the diagnosis of such dual primaries before surgery, particularly if the histology at the two sites is different.