Incidence of occult cancer in patients diagnosed with adenocarcinoma in situ by cervical punch biopsy or endocervical curettage

ObjectivesTo investigate the incidence of occult cancer in patients diagnosed with adenocarcinoma in situ through punch biopsy or endocervical curettage. MethodsWe examined the clinicopathological characteristics of patients diagnosed with adenocarcinoma in situ using punch biopsy or endocervical curettage at four institutes in the Republic of Korea from 2003 to 2011. We investigated the incidence of occult cancer in conization or hysterectomy specimens and whether the occult cancer was detected through conization. ResultsTwenty patients diagnosed with adenocarcinoma in situ through punch biopsy or endocervical curettage were enrolled. Six out of the 20 patients had occult cervical cancer, and four out of the six patients had cervical cancer at or greater than stage 1A1 with lymphovascular space invasion. Two out of four patients were diagnosed with invasive cervical cancer through conization and underwent radical hysterectomy without adjuvant radiotherapy. The other two patients underwent extrafascial hysterectomy without preoperative conization and received adjuvant radiotherapy. ConclusionA significant number of patients diagnosed with adenocarcinoma in situ through punch biopsy or endocervical curettage have occult cancer. Conization should be performed to identify occult cancer and optimize the extent of surgery.