Invasive breast carcinoma - IARC

Melanotic, germ cell, lymphoid and
secondary tumours of the cervix
C.B. Gilks
S. Carinelli
Definition
A variety of primary benign or malignant
tumours of the uterine cervix that are not
otherwise categorized as well as secondary
tumours.
ICD-O codes
Malignant melanoma 8720/3
Blue naevus 8780/0
Yolk sac tumour 9071/3
Dermoid cyst 9084/0
Mature cystic teratoma 9080/0
Malignant melanoma
Definition
A malignant tumour of melanocytic origin.
Epidemiology
Malignant melanoma of the cervix is considerably
less common than vulvar or
vaginal melanoma with fewer than 30 well
documented cases re p o rted {396,
667,940}. All occurred in adults, and
a p p roximately one-half had spre a d
beyond the cervix at the time of pre s e n t a-
tion {396}.
Clinical features
These tumours commonly present with
abnormal vaginal bleeding.
Malignant melanomas are typically
described as polypoid or fungating, pigmented
masses. However, they may be
amelanotic and non-specific in appearance.
Fig. 5.45 Blue naevus of the cervix. Note the aggregates of heavily pigmented dendritic melanocytes within
the endocervical stroma.
Tumour spread and staging
Spread to the vagina is often present at
the time of presentation {396}.
Histopathology
A junctional component was reported in
approximately 50% of cases. In tumours
lacking a junctional component, exclusion
of the possibility of metastatic
melanoma to the cervix requires clinical
correlation. The histological appearance
of cervical melanomas is noteworthy for
the frequent presence of spindle-shaped
cells. Desmoplastic and clear cell variants
have also been re p o rted {940,
1306}. The immunophenotype of cervical
melanoma is indistinguishable from that
of other sites.
Prognosis and predictive factors
The prognosis for patients with cervical
melanoma is dismal, with only two
reports of patients surviving more than 5
years {1360,2893}.
A
B
Fig. 5.46 Malignant melanoma of the cervix. A The tumour shows junctional growth and transepidermal migration. B This tumour is composed of large epithelioid
cells with pleomorphic nuclei in association with melanin pigment. C Note the spindle cell growth pattern of malignant melanocytes.
C
Melanotic, germ cell, lymphoid and secondary tumours of the cervix 287