RESUMO
Adenocarcinomas of the lower genital tract are rare diseases, and most of them arise from the Bartholin glands. Villoglandular adenocarcinoma of intestinal type is a very uncommon neoplasm of unknown origin with only few cases described on the vulva and in the vagina. It is characterized by villoglandular architecture, mucinous-type epithelium with intestinal differentiation (goblet cells), and direct apposition of the tumor with the surface epithelium. We report a case that developed on the hymen of a 64-year-old woman and discuss its possible origin as arising de novo from the squamous epithelium.
Assuntos
Adenocarcinoma Mucinoso/diagnóstico , Carcinoma in Situ/diagnóstico , Hímen/patologia , Neoplasias Vulvares/diagnóstico , Adenocarcinoma Mucinoso/complicações , Adenocarcinoma Mucinoso/patologia , Adenocarcinoma Mucinoso/cirurgia , Carcinoma in Situ/complicações , Carcinoma in Situ/patologia , Carcinoma in Situ/cirurgia , Diagnóstico Diferencial , Epitélio/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Descarga Vaginal/etiologia , Neoplasias Vulvares/complicações , Neoplasias Vulvares/patologia , Neoplasias Vulvares/cirurgiaRESUMO
OBJECTIVE: To measure the recurrence rate of disease in women treated for cervical adenocarcinoma in situ (ACIS) by either hysterectomy or conservative surgical management. PATIENTS AND METHODS: One hundred patients with a histopathologic diagnosis of ACIS or glandular dysplasia were identified in a retrospective clinicopathological review. Sixty-seven of the 100 patients were managed conservatively by local excision and were followed up for a mean period of 59 months (range, 1-222 months). The remaining 33 patients underwent hysterectomy as the primary management method and were followed up for a mean of 88 months (range, 1-248 months). If there was histologic documentation of ACIS or invasive adenocarcinoma more than 1 year after treatment, this was considered a recurrence. RESULTS: A total of four recurrences were noted in the 100 patients, three in the conservatively managed group and one in the hysterectomy group. Two late recurrences were noted at 97 and 153 months, one each in the conservatively managed and hysterectomy groups. CONCLUSIONS: Women who have been treated for cervical ACIS require long-term surveillance for at least 10 years regardless of whether they have undergone hysterectomy or conservative management.
