Cervical Polyp Research Articles

Clinical significance of atypical glandular cells on cytology: 10 years' experience of a colposcopic referral center.

'Atypical glandular cells' (AGC) is an uncommon cytological result of cervical Pap smears which includes a wide of histopathological diagnoses, from benign to premalignant and malignant cervical disorders, endometrial cancer and, occasionally, other genital malignancies. This study aims to provide a comprehensive overview of AGC, assessing risk factors and clinical and histological features in affected patients. A retrospective analysis was conducted on a cohort of 239 women diagnosed with AGC between 2012 and 2022 at the 'Regional Referral Center for Prevention, Diagnosis and Treatment of HPV-related Genital Disorders', Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Following AGC detection, patients underwent colposcopy with endocervical sampling and endometrial assessment via pelvic ultrasound. Selective cases also received endometrial biopsies. Among a total of 190 women who underwent both colposcopy and endometrial assessment, 116 (61%) had negative clinical and histopathological findings. The remainder displayed various abnormalities: 36 women (18.9%) were found to have endometrial or cervical polyps, 23 (12.1%) were diagnosed with preinvasive cervical neoplasia, and 21 (10.9%) with invasive cervical or endometrial disease. Menopause, multiparity, and older age were all significantly associated with endometrial cancer, but none of the abovementioned variables were significantly associated with cervical neoplasia. Our data confirm that AGC may reveal the presence of a wide range of histopathological conditions. Patients diagnosed with AGC should undergo a careful evaluation including both colposcopy with endocervical sampling and an endometrial assessment.

Clinicopathological correlation of three cases of metastatic carcinoma to uterine cervix: An institutional experience

Abstract Introduction/Objective Metastasis to the female genital tract presents a rare occurrence and poses significant diagnostic hurdles. The uterine cervix, although less frequently implicated, presents additional challenges for metastatic spread owing to its diminutive dimensions, limited vascular perfusion, and abundance of fibrous tissue. Clinical manifestations often include abnormal vaginal bleeding in 62–75% of cases, frequently accompanied by involvement in other anatomical sites. Accurate identification of cervical tumor activity and its primary origin holds paramount importance for precise diagnosis, therapeutic stratagem, and prognostic assessment. Methods/Case Report Here we are reporting three cases that were encountered in our institution over a 5-year period. The first patient, a 63-year-old female with a history of breast cancer, six years later exhibited metastatic breast cancer in a cervical polyp, confirmed by positivity for AE1/AE3, GATA3, ER, and negativity for TTF-1, chromogranin, synaptophysin, PAX8, inhibin, calretinin, CDX-2, CD10, desmin, smooth muscle actin, S100, and HMB-45. The second patient, diagnosed with pancreatic adenocarcinoma, two years later manifested cervical metastasis confirmed via positive staining for CK7, CDX2, and focal p63, and did not express PAX8, vimentin, ER, p16, synaptophysin, and chromogranin. The third patient, diagnosed with lung adenocarcinoma, one year later presented with a cervical mass, histologically confirmed as metastatic lung adenocarcinoma via positivity for CK7, Napsin A, and TTF1, and negativity for PAX8, p16, p40, p53, GATA3, and ER. Results (if a Case Study enter NA) N/A Conclusion Given the challenges of identifying metastasis to the cervix, thorough diagnostic evaluation should be undertaken to differentiate primary versus metastatic disease in women with a history of non-cervical malignancy.

A Rare Case Report of Cervical Hemangiomatous Polyp.

The uterine cervix is a rare site for cavernous hemangiomas. Cervical hemangiomas are slow-growing tumors with characteristic histological findings, including dilated vessels with increased endothelial cells. Although their pathophysiology remains unclear, hormones are believed to play an important role in the development of these vascular tumors. They may be asymptomatic due to their small size, but they can cause gynecological and obstetrical complications, including abnormal uterine bleeding and impaired fertility. Due to their small size, conservative treatment is the first line of management. Hysterectomy is considered for refractory cases or for patients who are not of childbearing age. We present a case report of a 62-year-old postmenopausal female with postmenopausal bleeding and a polypoid mass hanging over the anterior cervical wall through its stalk. The surgical biopsy revealed no signs of neoplastic changes, with the only notable finding being a polypoidal lesion representing a cavernous hemangiomatous cervical polyp.

S100 and CD34 positive spindle cell tumors of the uterine cervix with EGFR mutation: a hitherto unrecognized neoplasm phenotypically and epigenetically overlapping with "NTRK-rearranged spindle cell neoplasms" of the uterus.

NTRK-rearranged spindle cell neoplasm represents an emerging entity included in the latest 5th edition of WHO classification of both soft tissue and female genital tumors. By immunohistochemistry, they are commonly positive for CD34, S100 protein, and CD30 and typically harbor fusions of kinase genes such as NTRK1/2/3, RET, and BRAF. In the gynecological tract, they typically affect the uterine cervix or uterine body. Most of the reported cases had fibrosarcoma-like morphology, occasionally showing perivascular and stromal hyalinization with only a few cases showing a less cellular spindle cell proliferation. Except for one case with RET fusion, all other gynecological cases harbored exclusively NTRK1/2/3 fusions. Besides kinase gene fusions, the analogous tumors in soft tissues may also harbor activating EGFR or BRAF point mutations, but no such case has been described in the uterus. Herein we are reporting two cases from the uterine cervix showing morphology and molecular features previously unreported at this anatomic site. The patients were 46 and 34years old and clinically presented with unremarkable cervical polyps each measuring 8mm in diameter. Histologically, both cases had a rounded polypoid outline and were composed of hypocellular proliferation of bland spindle cells lacking mitotic activity and growing in a fibrotic stroma which was punctuated by prominent small vessels with thick hyalinized walls. Immunohistochemically, both showed a diffuse expression of CD34, CD30, and S100 protein, whereas SOX10 was negative. Both cases harbored exon 20 EGFR mutation and did not reveal any fusions or significant copy number changes. The patient in case 1 was treated by hysterectomy with salpingectomy with no other residual tumor detected, and she was alive and well 27months after the diagnosis. The patient in case 2 had no other known tumors at the time of diagnosis, but no follow-up is available. We believe the reported cases represent a hitherto unrecognized variant of "NTRK-rearranged spindle cell neoplasms" of the uterine cervix with novel EGFR mutations.

Prevalence, Clinical Features, and Management of Cervical Polyps: A One-Year Study at Rabia Balkhi Hospital in Afghanistan.

Background Cervical polyps are benign growths from the cervical epithelium, found in 2% to 5% of the population. They usually appear as small, stalk-attached lesions ranging from pea to cherry size. Contributing factors include cervical infections, congestion, and elevated estrogen levels. During pregnancy, these polyps may increase the risk of late abortion and preterm birth. While malignancy is rare, histopathological examination after removal is advised to rule out cancer. Materials and methods This current study, the first of its kind in Afghanistan, aimed to assess the scope of cervical polyps among Afghan women presenting to Rabia Balkhi National Hospital in 2018. We conducted a descriptive study of cervical polyps, exploring the prevalence, symptoms, complications, and procedures used to remove them. Data were collected from 3730 cases admitted to the hospital. Results Out of 3730 cases, 50 patients (1.34%) were diagnosed with cervical polyps. The polyps varied in size and were typically attached to the cervix by a slender stalk. Symptoms reported included inter-menstrual, post-coital, and post-menopausal bleeding. Histopathological examinations were performed following polyp removal to rule out malignancy. Conclusion This study provides a comprehensive overview of the prevalence and clinical presentation of cervical polyps among Afghan women. The findings highlight the importance of recognizing and managing cervical polyps to prevent potential complications, especially during pregnancy. Further research is needed to understand this population's epidemiology, pathogenesis, and optimal management strategies for cervical polyps.

Cervical fibroid: A diagnostic dilemma and operative challenge – one year study

: Cervical fibroids are very rare, with varying clinical presentations, and account for only 1–2% of cases. Cervical fibroids are enigmatic as they present with varying symptoms and simulate several clinical entities, for instance, a large cervical polyp, incarcerated procidentia, chronic uterine inversion, and the Ca cervix. : A two-year retrospective analysis of women diagnosed with cervical leiomyoma was conducted at Obstetrics and Gynaecology department, PGIMS Rohtak (a tertiary care institute in Northern India). A total of 24 cases diagnosed with cervical fibroid (CF) were studied. 75% of the females had vaginal bleeding, 44.6% had heavy menstrual bleeding, 33.3% had irregular bleeding, and one had postmenopausal bleeding. 41.6% had urinary symptoms; 1.5% complained of vaginal discharge; difficulty in stools (16.6%); and leiomyosarcoma (8.3%). We cannot find a clear demarcation of presenting symptoms between anterior and posterior fibroid. It was discovered that the development of malignancy and bladder and intestinal problems was linked to an increase in CF mass, while severe anaemia and vaginal bleeding were not. A cervical fibroid is mostly benign, can be present at extremes of age, and its atypical presenting symptoms pose difficulty in diagnosis. Vaginal bleeding and retention of urine are the most common symptoms. Central and supravaginal fibroids are difficult to operate. Proper pre-operative delineation of altered anatomical structure are essential for choosing the correct modality of treatment. In large cervical fibroids, suspected malignancy before surgery and hidden cervical malignancy can coexist.

The efficacy and safety of cervical polypectomy with vaginoscopy in pregnant women.

This study aims to assess the effectiveness and safety of cervical polypectomy performed via vaginoscopy in pregnant women. Pregnant patients diagnosed with cervical polyps were retrospectively included in Beijing Tiantan Hospital between April 2017 and April 2023. Group A underwent cervical polypectomy using a vaginoscopy technique without speculum, cervical forceps and anesthesia, while Group B received conservative management. The incidence of spontaneous abortion, preterm birth, preterm rupture of membranes (PROM), visual analog scale (VAS) scores, timing and method of delivery, and neonatal outcomes were analyzed. Of 90 pregnant patients included in the study, 48 patients receiving polypectomy under vaginoscopy were included into group A while 42 patients receiving conservative treatment were assigned into group B. At baseline, group A exhibited higher rates of vaginal bleeding pre-operation, as well as larger cervical polyp dimensions compared to group B. The median interval between vaginal bleeding and polypectomy was 3.5weeks, with the median procedure typically performed at gestational week 19 in group A. There was no significant difference in the incidence of spontaneous abortion between the two groups (4.2% vs. 4.8%, p = 1.000). However, group A showed a significantly lower frequency of preterm birth (4.2% vs. 21.4%, p = 0.030) and premature rupture of membranes (PROM) (18.8% vs. 45.2%, p = 0.025) compared to group B. No disparities were observed in the timing, mode of delivery, and neonatal outcomes between the two groups. The utilization of vaginoscopy for cervical polypectomy has been shown to decrease the likelihood of preterm delivery and premature rupture of membranes in pregnant women with symptomatic cervical polyps. Therefore, performing cervical polypectomy via vaginoscopy without anesthesia provide a feasible and optimal ways in the management of this population.

Giant Endocervical Polyp with Malignant Characteristics in an Adolescent

Introduction: A cervical polyp is a flexible, friable, pedunculated neoplasm, mostly originating from the endocervical area. It is considered giant when it is >4 cm. Most are benign but they must be removed and subjected to histopathologic examination because they may present malignancy. Clinical Case: A 13-year-old female patient, with no personal pathological personal or familiar history, was referred from another health center due to a 1-year history of a vaginal tumor with apparently no underlying cause. Physical examination showed a red, multilobulated, vaginal tumor of approximately 10 cm long, with mucus around it, foul-smelling, easy bleeding, painful on palpation, protruding from vaginal introitus with a deep pedicle. The patient underwent surgery where the excision of the vaginal tumor extending to the exocervix was performed. Conclusion: In this case, due to the initial clinical characteristics, a malignant pathology (such as rhabdomyosarcoma) may be suspected, thus, complementary imaging and laboratory studies need to be performed, to rule out this diagnosis and offer an adequate and well oriented surgical treatment; a subsequent definitive histopathological study needs to be conducted to confirm that the lesion is compatible with an endocervical polyp, determining the patients prognosis and follow-up requirements.

Conundrum in primary care: should all cervical polyps be removed?

The management of asymptomatic cervical polyps has long been debated due to the scarcity of literature and guidelines regarding the need for polypectomy. While the majority of cervical polyps are diagnosed incidentally by GPs during routine cervical smears, there are no clear recommendations on referral pathways for further histological investigations. To investigate the need for polypectomy in women presenting with asymptomatic polyps. In addition, the study explores potential suggestions and guidelines for the referral of asymptomatic cervical polyps in general practice. A retrospective study on the histological findings of extracted cervical polyps examined by the pathology department at the Countess of Chester Hospital (COCH) over 9 years (2010- 2019). Of the 514 patients presented with cervical polyps (74% were asymptomatic), approximately 97% of the referrals made were by GPs. Additionally, we identified 74 inappropriate referrals through the 2-week wait cancer pathway. Overall, there were no malignant samples and five (0.97%) premalignant lesions were presented. This study supported the evidence that most cervical polyps are benign. However, inappropriate referrals prompt more education on cervical pathologies. Furthermore, there is a need for robust guidelines on the management of asymptomatic cervical polyps in general practice. To lessen the financial burden of managing cervical polyps in a secondary care setting, workshops on polyp removal can be developed for GPs.

Use of statins and risks of ovarian, uterine, and cervical diseases: a cohort study in the UK Biobank

PurposeTo examine the associations between use of statins and risks of various ovarian, uterine, and cervical diseases, including ovarian cancer, endometrial cancer, cervical cancer, ovarian cyst, polycystic ovarian syndrome, endometriosis, endometrial hyperplasia, endometrial polyp, and cervical polyp.MethodsWe conducted a cohort study among female participants in the UK Biobank. Information on the use of statins was collected through verbal interview. Outcome information was obtained by linking to national cancer registry data and hospital inpatient data. We used Cox proportional hazards regression to examine the associations.ResultsA total of 180,855 female participants (18,403 statin users and 162,452 non-users) were included. Use of statins was significantly associated with increased risks of cervical cancer (adjusted hazard ratio (HR), 1.55; 95% confidence interval (95% CI), 1.05–2.30) and polycystic ovarian syndrome (adjusted HR, 4.39; 95% CI, 1.68–11.49). However, we observed no significant association between use of statins and risk of ovarian cancer, endometrial cancer, ovarian cyst, endometriosis, endometrial hyperplasia, endometrial polyp, or cervical polyp.ConclusionOur findings suggest that use of statins is associated with increased risks of cervical cancer and polycystic ovarian syndrome, but is not associated with increased or decreased risk of ovarian cancer, endometrial cancer, ovarian cyst, endometriosis, endometrial polyp, or cervical polyp.

STATISTICAL ANALYSIS OF ABNORMAL UTERINE BLEEDING AMONG MALDIVIAN WOMEN OF REPRODUCTIVE AGE

Introduction. Abnormal uterine bleeding (AUB) describes uterine bleeding that varies from the usual parameters of a normal menstrual cycle [3]. AUB is one of the most common gynecologic problems among women of reproductive age. Approximately one-third of women experience AUB at some point in their lives [1]. Purpose of the study. This study aims to explore the prevalence and causes of AUB among Maldivian women of reproductive age who have experienced menstruation. Materials and method. An online questionnaire survey was conducted among reproductive-age Maldivians who have experienced menstruation. The study population was analyzed through exploratory data analysis. Research result. From the data collected, out of 110 participants, 37 (33.6%) individuals reported having irregular menses. Additionally, 22 (20%) individuals experienced menorrhagia. Moreover, 16 (14.5%) reported polymenorrhea, 14 (12.7%) reported amenorrhea and 9 (8.2%) reported oligomenorrhea. According to the data interpreted from the menstrual pictogram, it was observed that among the 35 participants self-reporting heavy menstrual bleeding, merely 20% (7 individuals) actually had a menstrual blood loss (MBL) exceeding 80ml. The average blood loss among these individuals was calculated to be 113 ml, highlighting a notable disparity between subjective perception and objective data. Out of the 68 individuals who reported a normal flow, 4 had a MBL exceeding 80ml, with a mean of 116.19 ml. Moreover, among the entire study group, 44 (40%) participants reported having a diagnosis of polycystic ovarian syndrome (PCOS), and 18 (16.4%) individuals reported having ovarian cysts. Furthermore, 2 (1.8%) individuals reported endometriosis, 2 (1.8%) individuals reported having uterine fibroids and, 2 (1.8%) individuals mentioned having cervical polyp, and 1 (0.9%) had an endometrial polyp. Conclusion. Using FIGO system 1 as a gateway to FIGO system 2 simplifies the process of investigating AUB [2]. Based on the criteria set by FIGO system 1, only 46 (41.8%) out of the 110 participants in the study were found to have a normal menstrual cycle. The remaining 64 (58.2%) participants experienced AUB. Out of these 64 (58.2%) participants, a total of 29 individuals have a diagnosis of PCOS. These findings suggest a significant association between AUB and PCOS within the study population.

Histological changes of endocervical polypoid lesions in women at reproductive age

Abstract Background: Endocervical polyps (ECP) are fragile benign protrusions commonly affecting 2%–5% of women during the reproductive age. Aim: This study aimed to identify the histopathological changes of clinically identified endocervical polypoid lesions during the reproductive age to detect any premalignant or malignant transformation if present. The objective is to assist the clinicians to decide whether the cervical polyps should be excised or not. Materials and Methods: Sixty specimens of the resected cervical polyps were obtained from Al-Salaam Teaching Hospital in Mosul city during the period from June 2021 to February 2022, women diagnosed to have cervical polyps on per speculum examination were given a time to be operated on with exclusion of pregnant, postmenopausal women, those on hormone replacement therapy, and those below 20 years. After polypectomy, fixation of biopsies in 10% buffered formalin was done followed by processing and staining with hematoxylin and eosin for histological examination. Chi-square test was used for interpretation of the histological findings. Results: The study revealed that 52% of the enrolled women were in the range of 40–49 years of age. Squamous metaplasia and benign microglandular hyperplasia were detected equally in 25% of the study group. Nabothian cyst was observed in 8%, whereas leiomyoma presenting as cervical polyp in 6%. Fortunately, no malignant changes were reported in the examined 60 cases and the only serious lesion was cervical intraepithelial neoplasia (CIN) observed in 2% of the examined polyps. Conclusion: we conclude as the incidence of malignant transformation of endocervical polyp is low in women in reproductive age and the only critical lesion is in situ intraepithelial neoplasia (CIN), it is proposed to follow an expectant management without interference and those patients can be only followed up to improve their health.

Clinicopathologic characteristics, treatment, prognosis and pregnancy outcomes in rhabdomyosarcoma of the uterine cervix: a case series.

In this retrospective observational study, cases from our institution were included and the published literature reviewed to investigate the diagnosis and prognosis of cervical rhabdomyosarcoma, a rare group of tumours. The clinicopathological data of 12 patients with cervical rhabdomyosarcoma (RMS) treated at the West China Second University Hospital of Sichuan University from January 2006 to May 2023 were collected, and their clinicopathological characteristics, diagnoses, treatments, prognoses and pregnancy outcomes were retrospectively analysed. (1) Clinical characteristics: The ages of the 12 RMS patients ranged from 15 to 50 years, with a median age of 17 years. Five of the patients were adults, and seven were adolescents. The initial symptoms were vaginal bleeding in 5 patients, vaginal tissue prolapse in 6 patients, and abdominal pain and urinary frequency in 1 patient. Two patients were considered to have "cervical polyps" and underwent polypectomy at the other hospitals, but the cervical mass recurred soon thereafter. (2) Pathological features: The maximum tumour diameter ranged from 3 to 25 cm. The twelve cases of cervical RMS consisted of embryonal rhabdomyosarcoma (ERMS) in 7 adolescents, ERMS in 3 adults, and pleomorphic rhabdomyosarcoma (PRMS) in 2 adults. Immunohistochemical results showed the expression of one or more characteristic markers of RMS. We reclassified tumour stage according to the Intergroup Rhabdomyosarcoma Study (IRS) clinical group and tumour node metastasis (TNM) classification. (3) Treatment: Eight patients underwent radical surgery (66.7%, 8/12), including all 5 of the included adults and 3 of the adolescents, 2 of whom were treated 10 years ago. Conservative surgical resection was performed on four patients (33.3%, 4/12), all of whom were adolescents. Postoperative chemotherapy was given to all patients except one, but one patient who underwent radical surgery discontinued chemotherapy on her own without receiving a full course. Two of the ERMS patients underwent preoperative chemotherapy, and the lesions were significantly reduced. (4) Prognosis: One of the 12 patients with cervical RMS was lost to follow-up. Of the remaining 11 patients, 10 (including seven adolescents and three adults) survived tumour free (90.9%, 10/11), and 1 adult patient with existing pulmonary multiple metastases (IRS stage IV, T2N0M1) at the initial diagnosis survived 9 months with progression-free disease (9.1%, 1/11). The median survival time was 91 months (5 to 213 months). Among 4 patients receiving fertility-sparing management, 1 conceived and delivered successfully (25%). The treatment of cervical RMS must take the patient's age and reproductive intent into account. The overall prognosis for cervical RMS in children and adolescents is good, and conservative surgical resection combined with chemotherapy is recommended to preserve fertility. The pregnancy outcome is also worth anticipating. For patients who have completed childbirth, radical surgery is preferred. Approaches to accurately assessing the patient's condition, grasping the indications and scope of surgery, and developing chemoradiotherapy regimens deserve further exploration.

Cervical aggressive angiomyxoma – a rare case report

Aggressive angiomyxomas are rare tumours affecting the pelvic perineum of reproductive-age females with high recurrence rates. Cervical aggressive angiomas are always reported after histopathological confirmation of cervical polyps, which warrants long term follow up.

EP20.25: Retrospective study of ultrasonographic findings and diagnostic accuracy in patients with cervical polyps during pregnancy

EP20.25: Retrospective study of ultrasonographic findings and diagnostic accuracy in patients with cervical polyps during pregnancy

EP20.11: Longitudinal changes of cervical polyps in pregnancy: an observation of 18 cases using transvaginal ultrasonography with B‐mode and SMI

EP20.11: Longitudinal changes of cervical polyps in pregnancy: an observation of 18 cases using transvaginal ultrasonography with B‐mode and SMI

The effect of disorders of the microbiota of the genital tract on the development of cervical canal polyps and their correction

The effect of disorders of the microbiota of the genital tract on the development of cervical canal polyps and their correction

Evaluation of Causes of Post-Menopausal Bleeding: A Hospital-Based Study

Midline cerebral congenital malformations, despite their relative rarity in the general population, with their high rate of Introduction: Postmenopausal bleeding is frequent in gynecology and occurs approximately in 5% to 10% of postmenopausal women. But most of the causes of post-menopausal bleeding are benign and treated conservatively. Women with postmenopausal bleeding have a primary or secondary malignancy of about 10%. So before starting treatment malignancy must be excluded. Common malignancies among them are endometrial or cervical carcinoma and rarely, ovarian cancer. The incidence of malignancy in the postmenopausal period remains sufficiently high, so it requires immediate investigations for early diagnosis, prompt treatment, and vigilant follow-up. The objective of the study is to evaluate the causes of postmenopausal bleeding in tertiary care hospitals in Dhaka city. Methods: This retrospective study was conducted at the Department of Obstetrics and Gynecology in Delta Medical College and Hospital, Dhaka, Bangladesh. The study duration spanned 12 months from July 2022 to June 2023. The study population consisted of 72 patients who presented with postmenopausal bleeding. The sampling for this study was conducted using a consecutive sampling method. Ethical approval was obtained from the ethical review committee of the study hospital. Descriptive statistics were used to summarize the demographic and clinical characteristics of the study participants. For the statistical analysis, the Statistical Package for the Social Sciences (SPSS). Results: Among 72 cases of postmenopausal bleeding, we found 9 cases of cancer (12.50%). Among them, 2 cases were cancer of the uterine cervix and 7 cases were cancer of the uterine corpus. Benign pathology was more frequent (63 cases: 87.50%), essentially presented atrophic endometritis 15 cases(20.83%), endometrial hyperplasia without atypia27.78% cases, endometrial polyp 16.67% cases, endocervical polyp 5.56% cases, cervical polyp 8.33%, leiomyoma found in 5.53% cases and preinvasive disease about 2.78% cases. Histopathological findings in 2 cases of carcinoma cervix were invasive squamous cell carcinoma and 7cases of endometrial cancer were endometrial adenocarcinoma. Cancer increased with advanced age while the incidence of bleeding decreased with age. Within 45 to 65 years of age is more frequent to develop post-menopausal bleeding. Conclusion: Even though causes of post-menopausal bleeding are mostly benign and treated conservatively but malignancy must be ruled out by endometrial and cervical biopsy.

Recurrent cervical adenofibroma progressing to adenosarcoma: a rare case report.

Cervical adenofibroma is a rare form of mixed mesodermal tumor that can present as cervical polyps with a tendency for local recurrence and progression. Few cases progressing to adenosarcoma have previously been reported. We report a case of cervical adenofibroma progressing to adenosarcoma, and we seek to remind clinicians of the method and importance of the differential diagnosis of this disease. A fertile woman was admitted in our department for the eighth recurrence of a cervical polypoidal mass which for the past 10 years. Recurrence of cervical adenofibroma was confirmed by ultrasound and MRI. A wide local excision under hysteroscopy was performed due to her strong desire to preserve the uterus. Surgical pathology and immunohistochemical interpretation revealed cervical adenosarcoma. A hysterectomy with conservation of the ovaries was recommended, with regular follow-ups for evidence of disease recurrence. Differential diagnoses of cervical adenofibroma are hard to prove. Adenosarcoma should be ruled out, especially in women presenting with recurrent cervical polypoidal masses. A combined histological/immunohistochemical investigation is mandatory.

Epidemiological features of the incidence of cervical intraepithelial neoplasia in the modern megapolis

Background. Information on the incidence of cervical intraepithelial neoplasia (CIN) is relevant for planning and evaluating the effectiveness of medical care at the stage of secondary prevention of cervical cancer. Aim. To analyze the incidence of CIN and benign diseases of the cervix: erosion and ectropion, leukoplakia, polyp, according to medical organizations in Yekaterinburg in 2013–2019. Materials and methods. A descriptive epidemiological study of the incidence of cervical pathology in the population of women in Yekaterinburg in 2013–2019 was conducted. The forms of Federal Statistical Observation No. 12 “Information on the number of diseases registered in patients living in the service area of a medical organization”, in terms of erosion and ectropion, and data from the city’s women’s consultations on the number of cases of CIN, leukoplakia and cervical polyp were examined. Information on the number of female population of the city from Sverdlovskstat was used. Results. The primary incidence of CIN increased throughout the follow-up period. The indicator increased by 1.7 times compared to 2013 (p < 0.001) in 2016, it had a maximum value in 2019 – 215.5 per 100 thousand women and was 3.2 times more than in 2013 (p < 0.001). The dynamics of the primary incidence of other types of cervical pathology: ectropion, leukoplakia and cervical polyp, was characterized by the absence of significant changes (p > 0.05) in 2013–2019. The increase in the overall incidence of CIN was registered from 2014 to 2019 in comparison with 2013 (p < 0.001). The indicator of the overall incidence of CIN in 2019 was 2.1 times higher than in 2013 (p < 0.001). Conclusions. The growth of primary and total incidence of CIN in the population of Yekaterinburg women noted since the beginning of the XXI century continued in 2013–2019. The primary incidence rate of CIN had the maximum value in 2019. The increase in the incidence of CIN is associated with the natural spread of the disease, accessibility and improvement in the quality of medical care.