Minimal-deviation adenocarcinoma of the cervix encountered during hysteroscopic endometrial ablation.
A 43-year-old, para 2, gravida 2 woman experienced menorrhagia. She had no risk factors for endometrial neoplasia, and five annual Papanicolaou smears, the last one 3 months earlier, were satisfactory for evaluation and within normal limits. During hysteroscopic endometrial ablation the endometrium appeared normal. The uterine-cervical cavity was normal other than a 1-cm, prominent, vascular, erythematous lesion in the posterior cervical canal, which was resected together with the entire endometrium. Pathology was reported as highly suggestive of a minimal-deviation adenocarcinoma of the cervix, and the patient underwent radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. No residual cancer was found in the surgical specimen and the patient was alive and well 1 year later. Preablation evaluation is not adequate to detect all gynecologic malignancies. Routine resection of all unrecognizable lesions may identify rare tumors such as the one discovered in this woman.
Vilos
George A
GA
Department of Obstetrics and Gynecology, St. Joseph's Health Care, 268 Grosvenor St., London, Ontario N6A 4V2, Canada.
Ettler
Helen C
HC
Carey
Mark
M
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D001707:Biopsy, Needle; D017115:Catheter Ablation / Q000379:methods; D004717:Endometrium / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D015907:Hysteroscopy / Q000379:methods*; D007150:Immunohistochemistry; D009367:Neoplasm Staging; D010052:Ovariectomy / Q000379:methods; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*