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Adenocarcinoma In Situ of the Cervix-Controversies in Diagnosis and Treatment

2001; Lippincott Williams & Wilkins; Volume: 5; Issue: 2 Linguagem: Inglês

10.1046/j.1526-0976.2001.005002094.x

1526-0976

Ian J. Etherington, David Luesley,

Endometrial and Cervical Cancer Treatments

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.