Cervical adenocarcinoma in situ
Endocervical adenocarcinoma in situ
Updated: 01/04/2021
© Jun Wang, MD, PhD
General features
- Malignant appearing glandular epithelium without invasion
- Significant risk of invasive adenocarcinoma if not treated
- Much less common than SIL
- Younger population
- Usually multifocal
Clinical presentations
- Usually asymptomatic
Key risk factors
- High risk HPV, particularly types 16 and 18
Key pathogenesis
- HPV products
E6: Promotes degradation of p53 and abnormally activates telomerase
E7: Suppresses retinoblastoma 1, a tumor suppressor
Key morphological features
- Crowded enlarged hyperchromic nuclei (pencillike)
- Mitosis in apical side
- No invasion
- Hysterectomy
- Conization with surveillance if fertility preservation desired
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