title: Conservative treatment of coexisting microinvasive squamous and adenocarcinoma of the cervix: report of two cases and literature review.
abstract: Coexistence of microinvasive squamous cell carcinoma (MISCC) and microinvasive adenocarcinoma (MIAC) of the cervix is a rare phenomenon with very few clinically significant cases described in the literature. While a conservative approach has been studied, and may be effective in MISCC, a lower number of studies that recommend conservative treatment are available for MIAC. We report two cases of synchronous cervix lesions in two separate foci, MISCC and MIAC, who underwent fertility-sparing treatment with long-term follow-up. We describe clinical, histological, and immunohistochemical features of the two cases. The first case is a 41-year-old female with a diagnosis of MIAC of endocervical type, grade 1 differentiation, with a stromal invasion, associated with a separate area of squamous cell carcinoma (International Federation of Gynecology and Obstetrics/TNM stage: pT1a1G1). The second case is a 45-year-old female with a diagnosis of plurifocal MISCC, associated with an MIAC of endocervical type with a stromal invasion (International Federation of Gynecology and Obstetrics/TNM stage: pT1a1G1). After multidisciplinary counseling, both patients accepted conization as definitive treatment. Eleven years after the conization, all tests (Papanicolaou smear, colposcopy, cervical curettage, and hybrid capture 2-human papillomavirus test) planned quarterly in the first year and every 6 months in the subsequent years were negative in both patients. In women affected by stage IA1 squamous cervical cancer coexisting with stage IA1 adenocarcinoma endocervical type, with clear margins, and without lymphovascular space invasion, cervical conization may be considered a fertility-preserving, safe, and definitive therapeutic option.
authors: Gynecologic Oncology Unit, Department of Surgical Oncology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy.
authors: Francesco
authors: F
authors: Sopracordevole
authors: Woman's Health Sciences Department, Gynaecologic Section, Polytechnic University of Marche, Ancona, Italy.
authors: Jacopo
authors: J
authors: Di Giuseppe
authors: CRO-Biobank, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy; Clinical Cancer Pathology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy.
authors: Silvia
authors: S
authors: Cervo
authors: Gynecologic Oncology Unit, Department of Surgical Oncology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy.
authors: Monica
authors: M
authors: Buttignol
authors: Gynecologic Oncology Unit, Department of Surgical Oncology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy.
authors: Giorgio
authors: G
authors: Giorda
authors: Woman's Health Sciences Department, Gynaecologic Section, Polytechnic University of Marche, Ancona, Italy.
authors: Andrea
authors: A
authors: Ciavattini
authors: CRO-Biobank, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy; Pathology Unit, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy.
authors: Vincenzo
authors: V
authors: Canzonieri
keywords: FIGO stage; cervical conization; cervical lesions; microinvasive adenocarcinoma; microinvasive squamous cell carcinoma; uterine cervical neoplasms