Villoglandular papillary adenocarcinoma of the uterine cervix. A clinicopathologic analysis of 13 cases.

The clinical and pathologic features of 13 cervical papillary adenocarcinomas of villoglandular type were reviewed. They occurred in patients 23 to 54 years of age, with ten patients younger than 40 years of age. Microscopic examination revealed surface papillae that ranged from tall and thin to short and broad and contained central fibrous cores typically containing numerous inflammatory cells. The papillae were usually lined by stratified epithelial cells with slight to moderate nuclear atypicality and mitotic activity and no more than a minor degree of cellular budding. The deeper portions of the tumors were composed of branching tubular glands separated by a fibrous or fibromatous stroma and were more or less sharply demarcated from the adjacent cervical stroma. A hysterectomy was performed in 12 cases and only a cone biopsy in one case. The cone biopsy specimen and four of the hysterectomy specimens contained no residual carcinoma. In six uteri adenocarcinoma was confined to the inner third of the cervical wall whereas in two there was deep invasion. Follow-up of 2 to 14 years' duration including more than 5 years in ten cases has revealed no evidence of recurrent tumor. The excellent prognosis of the patients in this small series and the young age of many of them suggest that this tumor may be managed by a procedure less radical than a hysterectomy provided the tumor is superficial, has been completely excised, does not exhibit vascular space invasion, and close follow-up examination is possible.