title: Adenocarcinoma in situ of the cervix-controversies in diagnosis and treatment.
abstract: Adenocarcinoma in situ (AIS) of the uterine cervix is a rare condition. Pap smear screening is unsatisfactory, and the disease has no morphologic reliable colposcopic features. Diagnosis is often made by chance during the treatment of squamous pre-invasive disease, which commonly coexists with AIS. Although the entire endocervical canal can be the site of disease, most lesions lie within 1 cm of the squamocolumnar junction. Skip lesions are rare, making fertility-sparing surgery a possibility under certain conditions. Recurrent disease occurs in 14% of cases when cone margins are free of disease and rise to more than 50% if the margins are involved. The method of conization is immaterial provided a large enough specimen is taken and that the endocervical margins can be evaluated by the pathologist. Follow-up of conservatively managed women is not defined; however, we recommend that regular endocervical cytology be performed in addition to conventional cytology and colposcopy.
authors.affiliation: *City Hospital NHS Trust, Dudley Road, Birmingham, B18 7QH, UK †Academic Department of Obstetrics & Gynaecology, Birmingham Womenʼs Hospital and University of Birmingham, Birmingham, B15 2TT, UK.
authors.forename: I J
authors.initials: IJ
authors.lastname: Etherington
authors.forename: D M
authors.initials: DM
authors.lastname: Luesley