Evolution of endocervical adenocarcinoma in situ: A retrospective case series study

Abstract

The management and follow-up of patients diagnosed with adenocarcinoma in situ (AIS) is challenging. First, complete resection is difficult and cannot be guaranteed even though resection margins are negative. Second, patients with positive margins and/or positive endocervical curettage and/or histological signs of invasive disease have a very high risk of invasive adenocarcinoma. Therefore, the optimal management of these patients remains uncertain. A 15-year retrospective study was performed of patients with AIS treated in the Unit of Gynecology of Miguel Servet University Hospital, Zaragoza, Spain. During this period, a total of 18 women were diagnosed with AIS. Initial treatment consisted of cervical conization in all patients. Histological examination of the hysterectomy specimen showed the presence of residual disease in 60% of patients with positive margins, whose treatment was completed with a hysterectomy. All patients with negative cone margins who did not receive any complementary therapy were closely monitored and currently remain disease-free.