Villoglandular Adenocarcinoma of the Uterine Cervix: An Analysis of 12 Clinical Cases

Abstract

Villoglandular adenocarcinoma (VGA) of the uterine cervix is a relatively rare subtype of endocervical adenocarcinomas that often occurs in early reproductive women. Clinical cases were retrospectively collected from the cancer registry systems at Mackay Memorial Hospital (Taipei, Taiwan). Clinical histories on the subjects were extracted directly from chart review of records of clinic visits. The mean age of 12 subjects was 42 years, with 10 and 2 subjects clinically staged as IB1 (10 of 12) and IA2 (2 of 12), respectively, for the period between January 1, 1996, and December 31, 2007. Eleven subjects had classical Type III radical hysterectomy with or without bilateral salpingo-oophorectomy plus bilateral pelvic lymphadenectomy, and one received pelvic and para-aortic lymphadenectomy plus postoperative adjuvant treatment of weekly cisplatin concurrent with radiotherapy. Only one subject had confirmed pelvic lymph nodes metastases. Nine subjects had pure histologic type and others had mixed histologic type of VGA. Only one subject had a recurrence but was still alive. Most subjects were long-term survivors (greater than 5 years) (10 of 12). In conclusion, this study confirms the young age of subjects with VGA and reemphasizes the difficulties in the diagnosis of VGA. Because the current management strategy renders good tumor control in young subjects with early-stage VGA, we would suggest that similar treatment should be considered for elder subjects with this rare category of cervical malignancy. Our experience shows that the primary management of subjects with early-stage VGA (International Federation of Gynecology and Obstetrics Stages IA2 to IIA1) is classical Type III radical hysterectomy plus salpingo-oophorectomy with bilateral pelvic lymphadenectomy at MMH. We hope our 12-case experience may contribute to the clinical decision making for subjects with this disease.