Well-Differentiated Villoglandular Adenocarcinoma of
the Uterine Cervix: A Report of 15 Cases Including
Two with Lymph Node Metastasis
SURAPAN KHUNAMORNPONG, M.D.*, SUMALEE SIRIAUNKGUL, M.D.*,
SUMONMAL MALEEMONKOL, M.D.**, AREE PANTUSART, B.Sc.**
Affiliation : * Department of Pathology,
** Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
AbstractWell-differentiated villoglandular adenocarcinoma is a recently described subtype of cer
vical adenocarcinoma. The tumor of this type is reported to have distinct clinicopathologic features
and excellent prognosis. However, lymph node metastases of this tumor have been described in
few reports. Fifteen cases of well-differentiated villoglandular adenocarcinoma treated at Maharaj
Nakorn Chiang Mai Hospital were retrospectively reviewed for both clinical and histopathological
features. All patients underwent radical hysterectomy with pelvic lymphadenectomy. In the cases
with lymph node metastasis, adjuvant radiation therapy was also given. The patients ranged in age
from 22 to 53 years (mean, 39.3). Fourteen patients were FIGO stage IB and one was stage IIA. All
patients had exophytic friable cervical masses. Tumor size known in 14 cases ranged from 1.5 to 4
em (mean, 2.3). Eleven tumors (73.3%) were confined to the inner third of the cervical stroma with
9 of these (60%) showing only superficial invasion (depth_$:. 3 mm). The tumors invaded deeply to
the middle third in 3 cases (20.0%), and to the outer third in one (6.7%). Lymphatic invasion was
observed in 3 cases, two of them had pelvic lymph node metastasis. Both patients had tumors
involving deeper than the inner third of the cervical wall. The follow-up duration ranged from 21
to 144 months (mean, 67.5). Four of thirteen cases without nodal metastasis were lost to follow-up
36 to 59 months after surgery. All patients showed no evidence of disease at the last visit. Pre
sence of lymphatic invasion and deep stromal involvement appeared to be the risk factors for lymph
node metastasis of well-differentiated villoglandular adenocarcinoma.
Keywords : Villoglandular Adenocarcinoma, Uterine Cervix, Lymph Node Metastasis
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