Cervical adenocarcinoma in situ
- Marcela G del Carmen, MD
Marcela G del Carmen, MD
- Department of Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
- Medical Director
- Massachusetts General Physicians Organization
- John O Schorge, MD
John O Schorge, MD
- Chief, Gynecologic Oncology
- Massachusetts General Hospital
Adenocarcinoma in situ of the uterine cervix is a premalignant glandular condition. Adenocarcinoma in situ is the only known precursor to cervical adenocarcinoma, and appropriate management can prevent the occurrence of invasive disease in many cases . The usual interval between clinically detectable adenocarcinoma in situ and early invasion appears to be at least five years, suggesting ample opportunity for screening and intervention [2,3].
Glandular neoplasia of the uterine cervix is less common than squamous neoplasia, comprising one quarter of all annual cervical cancers diagnoses in the United States . Over the past few decades, however, the incidence of adenocarcinoma in situ and invasive adenocarcinoma has increased .
The diagnosis and management of cervical adenocarcinoma in situ are reviewed here. Related topics are discussed separately, including:
●Glandular cells on cervical cytology (see "Cervical cytology: Evaluation of atypical and malignant glandular cells")
●Invasive adenocarcinoma of the cervix (see "Invasive cervical cancer: Epidemiology, risk factors, clinical manifestations, and diagnosis" and "Invasive cervical adenocarcinoma")
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- EPIDEMIOLOGY AND RISK FACTORS
- CLINICAL FEATURES
- Cervical cytology
- Pelvic examination
- Colposcopy, biopsy, and endocervical curettage
- DIFFERENTIAL DIAGNOSIS
- POSTDIAGNOSTIC EVALUATION
- Evaluation of coexistent squamous neoplasia
- Clinical approach
- - Procedure
- - Posthysterectomy follow-up
- - Outcome
- Fertility preservation
- - Conization margin status
- Negative margin
- Positive margin
- - Postconization follow-up
- - Outcome
- AIS or adenocarcinoma
- Reproductive outcomes
- PREGNANT WOMEN
- SUMMARY AND RECOMMENDATIONS