Rubesa-Mihaljević Roberta, Vrdoljak-Mozetic Danijela, Ostojić Damjana Versa, Stemberger-Papić Snjezana, Sindik Nebojsa, Krasević Maja
Department of Gynecological Cytology, University Department of Gynecology and Obstetrics, University Hospital Center Rijeka, Rijeka, Croatia.
Coll Antropol. 2010 Mar;34(1):291-4.
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.
宫颈腺管型乳头状腺癌（VGA）是一种罕见但已被充分认识的宫颈腺癌组织学亚型，通常影响年轻女性。基于大多数先前病例报告的良好结果，该肿瘤一般被认为临床病程惰性，预后良好。我们报告一例22岁女性，因宫颈涂片发现腺性异常及阴道分泌物增多入住我院。在巴氏涂片中，细胞学特征可疑但不能诊断为腺癌，因此报告为非典型腺细胞（AGC）。组织学检查证实为VGA伴淋巴管间隙浸润。患者接受了根治性手术。术中细胞学检查发现盆腔淋巴结转移。患者被确诊为晚期——国际妇产科联盟（FIGO）III B期。在两年的随访期内，肿瘤迅速播散，导致死亡。尽管据报道VGA预后良好，但已有几例伴有淋巴结受累的病例被描述。宫颈涂片检查有助于VGA的早期诊断，然而细胞学识别往往困难。需要对该肿瘤的发病机制、诊断和治疗进行进一步研究。
