Villoglandular papillary adenocarcinoma of the cervix – Report of 2 cases and a review of literature

Abstract

Villoglandular papillary adenocarcinoma (VGA) of cervix is a rare subtype of cervical adenocarcinoma frequently associated with human papillomavirus and oral contraceptives usage. It is mostly seen in younger women and it has excellent prognosis. We reported two separate cases, the first is a woman in her third trimester of pregnancy who was successfully managed by surgery and the second in another young woman with recurrent vaginal bleeding complicated by severe anemia. The first patient has localized complete excisional biopsy which confirmed diagnosis of VPA while follow up type II hysterectomy showed no residual tumour. She was discharged from the follow up clinic and was disease free 16 months after surgery. The second case presented with an advanced disease and was therefore referred for radiotherapy after the management of bleeding and anaemia. She however defaulted due to financial constraint but she is still alive at 12 months post diagnosis as at last contact with the social worker. VPA is a rare disease with excellent prognosis, occurs in younger women and can
be confused with or be a component of other variants of adenocarcinoma with poorer prognosis. Conservative treatment is advocated and once confirmed histologically, radical surgery may not be indicated even though one of our cases had such. Poverty is unfortunately a confounding factor in our environment as reflected by the second case presented.

Keywords: Villoglandular, Papillary adenocarcinoma, Human papilloma virus, Oral contraceptives, Pregnancy