Hidden carcinoma of uterine cervix

Abstract

The objectives were to evaluate the prevalence of Hidden Cervical Cancer (HCC), to analyze diagnostic and histopathological aspects, and clinical evolution of 677 patients with cervical cancer, attended from January 1995 through December 2013. The design was retrospective and observational. The diagnostic methods used were cytology, colposcopy and histopathological study of surgical specimens. The HCC was found in 68/677 patients (10,04%): 55,9% of which consulted for a medical checkup, 33,8% for metrorragia, 19,1% for sinusorragia, 2,9% for bleeding and 1,5% for inguinal node; whereas 62% of the patients with exocervical or exoendocervical cancer (EEC) consulted for bleeding, 23% for sinusorragia and vaginal discharge with odor, and 16% for a medical checkup (p< 0.0003). The cytology's sensitivity for HCC was 47,1% (CI 95%, 35.2-59), 36,8% were false negatives; whereas for EEC it was 69,1% (CI 95%, 65.4-72.8) and 12,3% respectively (p< 0.001). The colposcopy's sensitivity for HCC was 17,65% (CI 95%, 8.6-26.7); whereas for EEC it was 85,55% (CI 95%, 82.8-88.4; p< 0.0001). 30,9% of the cases of HCC were diagnosed by biopsies and 41,2% by surgical procedures; whereas 89,3% of the cases of EEC were detected in biopsies and 7,22% in surgical pieces (p< 0.0002). The torpid evolution of the disease, its rapid progression and death was significantly greater in patients with HCC than in patients with EEC (34,43% vs. 17,1%; P< 0.002), since HCC was diagnosed in more advanced stages and it had 19,12% adenocarcinoma and adenosquamous histology vs. 8,37% in EEC.Conclusions: patients with HCC had a worse evolution and poor outcome significantly greater than in patients with EEC. The use of virological tests in the screening would allow to detect HCC in early stages.

Villoglandular Papillary Adenocarcinoma With Cervical Intraepithelial Neoplasia 3 of the Cervix in a Woman With a Misdiagnosis of a Cervical Polyp

“…Krane et al reported that adenocarcinoma cells potentially mistaken for intimal cells in the lower uterus or cervical cells with tubo-endometrioid metaplasia were reasons for the lower detection rate of glandular cell abnormalities as compared with squamous epithelium abnormalities. Another reason is that squamous epithelial cells have lesions on the epithelial surface, whereas glandular epithelial cells may have lesions in crypts [ 9 ]. Therefore, atypical glandular cells in Pap smears may be diagnosed as adenocarcinoma.…”