A case study on incidental postoperative discovery of well-differentiated gastric-type adenocarcinoma of the cervix

Gastric-type adenocarcinoma (G-EAC) is a rare and highly aggressive histological subtype of cervical adenocarcinoma, often missed due to its concealed clinical manifestations and low sensitivity of cytological screening. This paper reported a 48-year-old female patient who underwent total hysterectomy and bilateral adnexectomy for "menstrual disorders accompanied by dysmenorrhea for more than one year". Postoperative pathological examination incidentally confirmed well-differentiated G-EAC. Histologically, the tumor cells cytoplasm exhibited extensive clear to foamy or pale eosinophilic, with mildly disordered glandular architecture and infiltration into the deep cervical stroma. Immunohistochemical features were consistent with the typical immunophenotype of G-EAC. There has been no disease progression during postoperative follow-up to date. Well-differentiated G-EAC may lack typical symptoms, and routine cervical cancer screeningsuch as thinprep cytologic test/human papillomavirus testing often yields negative results, making it highly susceptible to misdiagnosis or missed diagnosis. The identification of well-differentiated morphological features and specific immune markers (such as Claudin18.2 positivity), combined with meticulous pathological evaluation, is crucial for early diagnosis and individualized management.