A retrospective review of 11 cases of villoglandular papillary adenocarcinoma of the uterine cervix and a review of the literature

Abstract

Abstract. Villoglandular papillary adenocarcinoma (VGPA) of the uterine cervix is a rare subtype of cervical adenocarcinoma (AC) that accounts for 3.7-4.8% of cervical AC. Compared with ordinary adenocarcinoma, VGPA is associated with a lower incidence, younger age and better prognosis. Treatment with fertility-preserving surgery is also possible. The present study analyzed cases treated in The Second Hospital of Jilin University (Changchun, Jilin, China) between January 2010 and December 2014. A total of 11 cases were selected; of these, 7 cases were pathologically confirmed. The remaining 4 cases were diagnosed as VGPA upon the pathological examination of the biopsy, but confirmed as another type of adenocarcinoma upon analysis of the surgical pathology. The median age of the patients whose pathology was confirmed post-operatively was 36 years, and all cases were positive for human papillomavirus (HPV). As all 7 patients had no requirement for further fertility, a radical hysterectomy was performed, with or without adjuvant therapy. The follow-up time ranged from 7-57 months, with a mean time of 29 months. There was no evidence of recurrence in any of the patients. All the patients remain alive to date. The results of the present study indicated that HPV infection is likely to be the cause of VGPA, and the prognosis of VGPA tends to be better compared with other types of adenocarcinoma. However, the number of studies that have reported cases of VGPA remains small, and all are retrospective analyses with short follow-up times. Therefore, physicians selecting treatment options for patients with VGPA should exercise caution.

Clinical and MRI Characteristics of Uterine Cervical Adenocarcinoma: Its Variants and Mimics

“…It affects younger individuals, and the mean age at presentation is approximately 35 years (14). It has a good prognosis and fertility-preserving surgery may be considered if the tumor is in the early stage (115). Occasionally, CIN or AIS coexists with this tumor depending on its association with high-risk HPV infection (1).…”

Villoglandular Papillary Adenocarcinoma of the Uterine Cervix- A Rare Case Report

“…2 On microscopic examination, each papilla in the villoglandular structure, has a central pedicle that ranges in size and shape from short and thick to long and slender. 5 The central pedicle shows inflammatory cell infiltration. 5 The villoglandular structures are lined by stratified glandular cells, showing mild to moderate atypia and mitotic figures.…”

“…5 The central pedicle shows inflammatory cell infiltration. 5 The villoglandular structures are lined by stratified glandular cells, showing mild to moderate atypia and mitotic figures. 5 The epithelial lining can be of endometrial, endocervical or intestinal differentiation.…”

“…5 The villoglandular structures are lined by stratified glandular cells, showing mild to moderate atypia and mitotic figures. 5 The epithelial lining can be of endometrial, endocervical or intestinal differentiation. 2 Various authors have reported association of other patterns like squamous cell carcinoma, small cell carcinoma and adenocarcinoma in situ with VGPA.…”

“…6 Thus pre-treatment punch biopsy diagnosis has a lower diagnostic accuracy when compared with the final histopathology report. 5…”