title: Villoglandular papillary adenocarcinoma of the uterine cervix with aggressive clinical course--a case report.
abstract: Villoglandular papillary adenocarcinoma (VGA) of cervix is an uncommon but well recognized histologic subtype of cervical adenocarcinoma which usually affects young women. Based on the favorable outcomes reported in most previous cases the tumor is generally considered to have an indolent clinical course with excellent prognosis. We present a case of a 22-year-old woman admitted at our Department for glandular abnormality on cervical smear and episodes of vaginal discharge. In the Pap smear, the cytological features were suspicious but not diagnostic of adenocarcinoma, therefore reported as atypical glandular cells (AGC). Histological examination confirmed VGA associated with lymphovascular space invasion. The patient underwent radical operative procedure. Intraoperative cytologic examination detected pelvic lymph nodes metastasis. The patient was confirmed to be in an advanced stage - III B (FIGO). During a two years follow-up period a rapid dissemination of the tumor occurred and resulted with a fatal outcome. Although VGA has been reported to have a favorable prognosis, several cases with lymph node involvement have already been described. Cervical smears examination would be helpful for an early diagnosis of VGA, however the cytologic recognition is often difficult. Further investigation of the pathogenesis, diagnosis and therapy of the tumor is needed.
authors.affiliation: Department of Gynecological Cytology, University Department of Gynecology and Obstetrics, University Hospital Center Rijeka, Rijeka, Croatia. roberta.rubesa@gmail.com
authors.forename: Roberta
authors.initials: R
authors.lastname: Rubesa-Mihaljević
authors.forename: Danijela
authors.initials: D
authors.lastname: Vrdoljak-Mozetic
authors.forename: Damjana Versa
authors.initials: DV
authors.lastname: Ostojić
authors.forename: Snjezana
authors.initials: S
authors.lastname: Stemberger-Papić
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Sindik
authors.forename: Maja
authors.initials: M
authors.lastname: Krasević
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000556:secondary* / Q000601:surgery; D001706:Biopsy; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D012720:Severity of Illness Index; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery; D055815:Young Adult