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

Zhou,Qiang‑Yong; Chen,Hai‑Yan; Yang,Si‑Meng; Li,Yue‑Hua; Wu,Xue‑Qing

doi:10.3892/ol.2015.3944

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

Authors:
- Qiang‑Yong Zhou
- Hai‑Yan Chen
- Si‑Meng Yang
- Yue‑Hua Li
- Xue‑Qing Wu
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Affiliations: Department of Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
Published online on: November 18, 2015 https://doi.org/10.3892/ol.2015.3944
Pages: 837-841

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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.

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