A Retrospective Study and Literature Review of Cervical Villoglandular Adenocarcinoma: A Candidate Paradigm of Silva System Pattern A

The aim was to investigate the clinicopathologic characters of cervical villoglandular adenocarcinoma (VGA), the authors retrospectively reviewed 4 cases of VGA, including clinical characteristics, pathology, managements, together with outcome information. The median age of the patients was 42 (range: 37 to 58), with 3 of them presenting with stage IB disease and 1 presenting with IVB. Human papillomavirus infection was tested in 3 of the patients, with all positive with high-risk type. Three of the patients underwent a radical hysterectomy with bilateral salpingo-oophorectomy plus bilateral pelvic lymphadenectomy, and 2 of them underwent subsequent chemotherapy. One patient received a bilateral salpingo-oophorectomy plus pelvic and periaortic lymphadenectomy and postoperative radiochemotherapy. Lymph node metastasis was detected in 1 patient. The follow-up time ranged from 56 to 120 months (median: 70 mo). Except for 1 person who experienced recurrence, all patients are alive at present and no recurrence occurred. In conclusion, VGA is a rare subtype of adenocarcinoma of the uterine cervix with distinct exophytic, villous-papillary growth pattern and extremely excellent prognosis, which corresponds with pattern A in Silva system, while its underlying mechanism and genetic background is still far from well known.