Neoplasia Associated with Atypical Glandular Cells of Undetermined Significance on Cervical Cytology

Recurrent Colorectal Carcinoma Detected by Routine Cervicovaginal Papanicolaou Smear Testing

“…The most common primary sites of extrauterine carcinomas that present on cervicovaginal cytologic smears are ovary, gastrointestinal, and breast sources [3]. Few cases of metastatic colorectal cancer to the uterine cervix have been diagnosed in this manner [4][5][6]. We present recurrent colorectal cancer found by Pap smear screening.…”

“…High-grade squamous intraepithelial lesion accounts for 0.45% of these cytologic abnormalities [2]. Most abnormalities are due to cervical intraepithelial neoplasia, but abnormal Pap test results may be due to metastatic extrauterine cancer to the uterine cervix, especially in patients with previous cancer diagnoses [3][4][5][6][7][8][9][10][11][12]. The most common primary sites of extrauterine carcinomas that present on cervicovaginal cytologic smears are ovary, gastrointestinal, and breast sources [3].…”

Current Management of Low-Grade Squamous Intraepithelial Lesion, High-Grade Squamous Epithelial Lesion, and Atypical Glandular Cells

“…[32][33][34][35][36][37] Additionally, AGC and AIS with colposcopic evidence of CIN should still be managed by AGC protocols, as up to 50% of cases of AIS have coexisting CIN. [35][36][37][38][39][40] Age is also related to the potential pathologic findings in the evaluation of women with AGC. Women over age 50 have an 8% risk of uterine cancer compared to a 1% risk in premenopausal women, who are more likely to have CIN 2, CIN 3, or AIS diagnosed during the evaluation of AGC.…”

“…Women over age 50 have an 8% risk of uterine cancer compared to a 1% risk in premenopausal women, who are more likely to have CIN 2, CIN 3, or AIS diagnosed during the evaluation of AGC. [38][39][40][41][42][43] The management of women with AGC and negative colposcopy/endocervical curettage (ECC) should be triaged based on the AGC subclassification, which reflects stratified risks of significant disease. After initial negative colposcopy and ECC, women with AGC-NOS may be followed with cervical cytology at 4-to 6-month intervals until 4 consecutive smears are negative, after which the patient may return to annual screening.…”

“…If all of these evaluations are negative, conization should be considered. 40,41,43,44 In patients with AGC favor neoplasia or AIS, and the colposcopic evaluation and ECC are negative, a diagnostic cone biopsy is indicated. Cold-knife conization may be the preferred method to avoid the possibility of thermal artifact that may obscure margin status and identification of invasive disease.…”