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

Abstract

Abstract. To investigate the clinicopathological features, management and prognosis of villoglandular papillary adenocarcinoma (VGPA) of the uterine cervix, the current study presents 4 cases of VGPA of the uterine cervix. The median age of the patients was 55 years (range, 47-70 years), with all 4 patients presenting with stage Ib disease. Human papillomavirus (HPV) infection was detected in 3 patients; this was mainly HPV-16. No history of oral contraceptive use was found in these cases. While 2 of the patients underwent a radical hysterectomy with bilateral salpingo-oophorectomy plus bilateral pelvic lymphadenectomy, 1 patient underwent a radical hysterectomy with bilateral pelvic lymphadenectomy and the remaining patient received a simple total hysterectomy plus post-operative radiotherapy. Of these patients, only 1 had been correctly diagnosed pre-operatively. In 2 patients, the biopsy results had been interpreted as cervical adenocarcinoma, and in the third, the biopsy result was of cervical intraepithelial neoplasia. All 4 patients presented with cervical wall invasion, including invasion of the inner two-thirds in 1 patient. No lymphovascular space invasion or lymph node metastasis was detected. The follow-up time ranged from 49 to 83 months (median, 64 months), and the patients are currently alive and well, with no evidence of recurrent disease. Taking these results as a whole, VGPA is an uncommon type of cervical adenocarcinoma, characterized by its excellent prognosis. HPV infection is associated with the molecular pathogenesis of VGPA, while oral contraceptive use can be excluded. As the disease has a low pre-operative diagnostic accuracy, frequent cervical wall invasion and concomitant lesions, conservative treatment strategies should be carefully considered.

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

“…On gross examination, the tumours are mostly polypoidal or papillary neoplasms as seen in our case although occasionally they can present as infiltrative and friable lesions. 4 The three important histopathological features of VGPA are: an exophytic growth pattern; papillary architecture and mild to moderate nuclear atypia, all of which were seen in present case. 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.…”

A Retrospective Study and Literature Review of Cervical Villoglandular Adenocarcinoma: A Candidate Paradigm of Silva System Pattern A

“…The etiology of VGA is still obscure. HPV infection, particularly high-risk types, in the role of molecular pathogenesis of VGA has been put forward, 12 and high-risk types HPV were indeed detected in 3 of our 4 patients. In 1993, Jones et al 6 proposed a possible relationship between VGA and oral contraceptives (OC) usage.…”

Villoglandular Adenocarcinoma of the Uterine Cervix: A Case Report

“…Previously, oral contraceptive use was linked to the development of VGA [ 6 ]. Yet, recent studies have not demonstrated a significant relationship between oral contraceptive use and VGA development [ 7 ]. Conversely, HPV infection, particularly high-risk HPV, is considered a risk factor for VGA development [ 7 ].…”

“…Yet, recent studies have not demonstrated a significant relationship between oral contraceptive use and VGA development [ 7 ]. Conversely, HPV infection, particularly high-risk HPV, is considered a risk factor for VGA development [ 7 ]. A recent study suggests a potential influence of estrogen on carcinogenesis in cervical adenocarcinoma cases with high-risk HPV infection [ 8 ].…”