The Clinical Characteristics Of Minimal Deviation Adenocarcinoma Of The Cervix And Review Of Literatures

Objective:To investigate the clinical characteristics/diagnosis/treatment and prognosis of the minimal deviation adenocarcinoma of the cervix.Methods:The retrospective analysis was carried out to evaluate the clinical and pathological data of 7 patients with minimal deviation adenocarcinoma of the cervix treated in Women's Hospital, ZheJiang University School of Medicine, from 1999 to 2007. And review the literature to discuss the features.Results:The chief complaint is increased vaginal discharge (6/7), including 1 patient with menstrual disorders, and 1 with contact bleeding,1 patient presented menstrual disorders. Gynecological examination:cervical neoplasm was saw in 1 case, cervical erosion in 4 cases,2 cases of cervical smooth, cervical hypertrophy in 4 cases,2 cases can see Nessler'cyst; 6 patients of the total 7 patients have received the cervical cytological exam, of which 2 cases of cervical cytological smear(Pap) suggest benign variant cell, a case with the low-grade squamous intraepithelial lesion, the results of the other 3 cases are no intraepithelial neoplasia/malignant cells. The human papillomavirus infection did not detected in all the 7cases. According to the FIGO stage, 5 cases were stage I b1,2 cases were stageâ…¡b.3 cases have primary surgery in the same hospital,1 patient received hysterectomy+bilateral adnexectomy+pelvic lymph node dissection, the pathologic concerned lymph node metastasis; 1 patient received extrafascial hysterectomy+bilateral adnexectomy, with the postoperative chemotherapy/radiotherapy,1 patient diagnosed before the surgery, and underwent modified radical hysterectomy+bilateral adnexectomy+pelvic lymph node dissection, adjuvant chemotherapy and radiotherapy; the other 4 patients underwent radiotherapy or chemoradiotherapy directly after diagnosis. The outcome of the 7 patients, lpatient died 21 months after surgery,1 patient have found recruuence 33months after the first treatment; 2 patient have no evidence of tumor recurrence or metastases for 45 months and 38 months, the other 3 cases were lost.Conclusions:Minimal deviation adenocarcinoma is a very special type of cervical adenocarcinoma, clinical diagnosis is very difficult, the most common clinical symptom was significantly increased vaginal discharge; and the result of cytological exam and HPV-DNA test were rarely positive, so it's usually misdiagnosis. The final diagnosis is based on histopathological examination, repeat cervical biopsy or cervical conization, combined immunohistochemistry is helpful for the diagnosis. For those patients who were diagnosis already, individualized treatment should be selected according to clinical stage.