A Rare Coexistence of Villoglandular Papillary Adenocarcinoma of the Uterine Cervix and Brenner Tumor of the Ovary

Synchronous primary gynecological cancers have been reported to be seen rarely in the literature. In this report, we aimed to describe a 51-year-old patient with the coexistence of villoglandular papillary adenocarcinoma of the cervix uteri and Brenner tumor in the right ovary. She successfully underwent radical hysterectomy, bilateral salphing-oopherectomy and pelvic and para-aortic lymphadenectomy. 1. Introduction The coexistence of carcinomas of the cervix and ovary has been reported to be a rare situation in gynecological practice. It is often unclear whether this represents synchronous primary tumors or metastasis that consequently alters staging, management, and expected outcome of these patients. In a study by Kaminski and Norris [1], the incidence of concomitant ovarian cancers (both primary and metastasis) in patients with cervical carcinoma was reported to be as high as 16% and only 9% of those cases were primary ovarian tumors. In the same study, presence of the endometrioid type adenocarcinoma of the cervix was found to dictate the presence of the primary independent ovarian tumour. Villoglandular papillary adenocarcinoma (VPA) is a very rare subtype of adenocarcinoma of the uterine cervix. It has a good prognosis and generally occurs in women of child bearing age [2]. Although the etiology has not been well understood, oral contraceptive use and infection with human papilloma virus (HPV) are being suggested as the etiological factors. Our purpose in this case is to report a patient with a rare coexistence of cervical VPA and Brenner tumour of the ovary. 2. Case Description A 51-year-old female (gravida 3, parity 2) was admitted to the medical center after experiencing vaginal discharge and spotting for about 2 months. Approximately, 2 years prior to being admitted she had visited a different medical center and a pap smear test had been performed and exfoliated cells resulted in the diagnosis of atypical glandular cells of undetermined significance (AGUS). Following this diagnosis, it was recommended to the patient to undergo colposcopy and biopsy. But the patient failed to return. Her medical history was otherwise unremarkable. Her gynecological examination revealed an approximately ？cm vegetative polypoid lesion originating from the endocervical canal and protruding into the vagina. A transvaginal ultrasound revealed an endometrial thickness of 4？mm and a right ovarian solid mass measuring ？mm. Laboratory study revealed that cancer antigen (CA) 125 was 9.46？U/mL, CA15.3 was 8.6？U/mL, CA19.9 was 4.75？U/mL, and carcinoembryonic antigen (CEA)