%0 Journal Article
%T Conservative Treatment of Stage IA1 Adenocarcinoma of the Uterine Cervix during Pregnancy: Case Report and Review of the Literature
%A Francesco Sopracordevole
%A Diego Rossi
%A Jacopo Di Giuseppe
%A Marta Angelini
%A Pierino Boschian-Bailo
%A Monica Buttignol
%A Andrea Ciavattini
%J Case Reports in Obstetrics and Gynecology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/296253
%X Microinvasive adenocarcinoma (MIAC) of the uterine cervix is rare in pregnancy. Published data on conservative treatment of MIAC both in pregnant and nonpregnant women are scarce. A conservatively treated case of MIAC in a 13-week-pregnant woman after a diagnosis of atypical glandular cells (AGC) on pap smear at the 6th week of pregnancy is presented. The problems of suspected adenocarcinoma in situ (AIS) on biopsy and MIAC on cone biopsy in pregnancy, as well as the risks and benefits of a conservative treatment are discussed. After colposcopic guide laser cervical conization and expression of informed consent the patient underwent followup and vaginal delivery at 40 weeks plus 3 days of gestation. In this case, no obstetric complication has been recorded after the cervical conization, and after a followup of 18 months the patient was alive and free of disease, with negative results as far as pap smear, colposcopy, HPV status, and cervical curettage are concerned. In a stage Ia1 disease of endocervical type, with clear margins and without lymph-vascular space invasion, cervical conization performed during the second trimester may be considered a definitive and safe treatment, at least up to delivery, after expression of informed consent by the woman. 1. Introduction Microinvasive adenocarcinoma of the cervix (MIAC) is occasionally found in the definitive histology in the specimens of conization performed because of squamous or glandular intraepithelial cervical neoplasia or suspicious for adenocarcinoma in situ (AIS). MIAC corresponds to FIGO stages Ia1 and Ia2, and its frequency, compared to all microinvasive cervical cancers (MICC), is about 12% [1]. The large presence of cytological-based screening programs in developed countries led to an increasing number of diagnoses in younger women [2], often in childbearing age. There are enough data on the safety of fertility-sparing treatment of squamous microinvasive cancers (MISC) [3¨C5] but few on fertility sparing treatment of MIAC [6, 7], in particular, with long-term followup [8, 9]. The occurrence of cervical cancer during pregnancy involves ethical and technical problems, related to the survival of the woman and fetal viability. Although the conservative treatment of MISC [10, 11] and small stage IB1 squamous cancer during pregnancy [12, 13] seems to be safe, scarce data are available for MIAC conservative treatment in pregnancy [2]. This case report is an addition to the few published cases of conservatively treated MIACs during pregnancy. 2. Case Presentation A 32-year-old pregnant woman, PARA 0000,
%U http://www.hindawi.com/journals/criog/2014/296253/