Villoglandular papillary adenocarcinoma of cervix: A prognostic dilemma

Adenocarcinomas are the second most common type of cervical cancers in women comprising 10-20% of the cases. Villoglandular papillary carcinoma is a rare histological subtype of invasive adenocarcinoma which usually afflicts young women and carries an excellent prognosis. However, additional histological subtypes mixed with villoglandular papillary adenocarcinoma are very common; therefore, a careful inspection of the specimen should be undertaken and only if it is an exclusive or almost exclusive pattern, should a diagnosis of villoglandular papillary adenocarcinoma be made. This is because the mixed patterns do not present with the same favorable prognosis as the villoglandular adenocarcinoma; moreover, the treatment modalities would also differ. One should consider whether conservative therapy is sufficient because of the predominance of concomitance of other carcinomas besides the villoglandular papillary adenocarcinoma. We present the case of a 47-year-old lady who, on initial biopsy from cervical growth, revealed a villoglandular adenocarcinoma, but subsequent hysterectomy revealed moderately differentiated adenocarcinoma with extrauterine extension.