Villoglandular papillary adenocarcinoma of the uterine cervix. A clinicopathologic analysis of 13 cases

Abstract

The clinical and pathologic features of 13 cervical papillary adenocarcinomas of villoglandular type were reviewed. They occurred in patients 23 to 54 years of age, with ten patients younger than 40 years of age. Microscopic examination revealed surface papillae that ranged from tall and thin to short and broad and contained central fibrous cores typically containing numerous inflammatory cells. The papillae were usually lined by stratified epithelial cells with slight to moderate nuclear atypicality and mitotic activity and no more than a minor degree of cellular budding. The deeper portions of the tumors were composed of branching tubular glands separated by a fibrous or fibromatous stroma and were more or less sharply demarcated from the adjacent cervical stroma. A hysterectomy was performed in 12 cases and only a cone biopsy in one case. The cone biopsy specimen and four of the hysterectomy specimens contained no residual carcinoma. In six uteri adenocarcinoma was confined to the inner third of the cervical wall whereas in two there was deep invasion. Follow-up of 2 to 14 years' duration including more than 5 years in ten cases has revealed no evidence of recurrent tumor. The excellent prognosis of the patients in this small series and the young age of many of them suggest that this tumor may be managed by a procedure less radical than a hysterectomy provided the tumor is superficial, has been completely excised, does not exhibit vascular space invasion, and close follow-up examination is possible.

Villoglandular papillary adenocarcinoma of the uterine cervix: A report of 4 cases and a review of the literature

“…The disease was described for the first time by Young and Scully (2) in 1989, and predominantly affects young women (2)(3)(4)(5)(6)(7). Based on its infrequent lymphovascular space invasion and lymph node metastasis, VGPA is generally considered to have relatively indolent behavior and an excellent prognosis compared with other types of cervical adenocarcinomas (2)(3)(4)(8)(9)(10). The conservative management of VGPA is widely recognized due to its favorable outcome and young patient age, particularly in those individuals who want to preserve their fertility (2,3,11).…”

Villoglandular Papillary Adenocarcinoma of the Uterine Cervix in a Pregnant Woman: A Case Report and Review of Literature

“…Over 45 cases of VPA of the cervix reported in the literature (Gilks and Clement 1992;Jones et al 1993;Costa et al 1995;Hurteau et al 1995;Skopelitou and Hadjiyannakis 1996;Stanley-Christian et al 1997;Borgo et al 1998;Lu et al 1998;Zhou et al 1998;Chang et al 1999;Lakhtakia et al 2000;Yamazawa et al 2000). After the description of the first 13 patients by Young and Scully (1989), 24 cases were reported by Jones et al (1993) and 7 by Kaku et al (1997), and 4 by Costa et al (1995), and 3 by Hopson et al (1990). This is the second pregnant patient with VPA after the description by Hurteau et al (1995).…”

“…Villoglandular papillary adenocarcinoma of cervix was described as a distinct entity (Young and Scully 1989). It occurs generally in young women with an average age of 35 years.…”

Villoglandulary papillary adenocarcinoma co-existing with high-grade squamous intraepitelial lesion; arising from an endocervical polyp

“…However, ADK VG has been reported to have a limited metastatic potential and an excellent prognosis (3,4,8). The excellent prognosis of this tumor raised the question of a conservative surgical approach, especially if the reproductive function needed to be preserved (3,4). In the literature, cases with long follow-up periods and underwent cervical conization have been reported only (3,4,9).…”

“…The excellent prognosis of this tumor raised the question of a conservative surgical approach, especially if the reproductive function needed to be preserved (3,4). In the literature, cases with long follow-up periods and underwent cervical conization have been reported only (3,4,9). Most of the authors had a radical surgical approach and in some cases, para-aortic lymph node dissection (5,6,10).…”