Cervical adenoid basal carcinoma, five cases and literature review

Adenoid basal carcinoma (ABC) is a rarely reported type of invasive cervical carcinoma with distinct clinical and pathological features. To make clinicians and pathologists more aware of this tumor and to investigate its pathogenesis, five new cases with human papillomavirus (HPV) DNA studies and a literature review of 30 cases were presented. The following tendencies of ABC were confirmed: occurrence in an older age group, absence of symptoms, abnormal Papanicolaou (Pap) smear, normal pelvic examination, endophytic growth pattern, associated cervical intra-epithelial neoplasia, low nuclear grade, absence of vascular space invasion, absence of nodal metastases, low stage and good prognosis. In contrast to previous reports, ABC was not found to be rare in the older age group and a spate of cases occured following a Pap smear campaign directed at older women. Human papillomavirus DNA was found in three of five cases. One was typed as HPV 16 and the other two were HPV MM4 and HPV 58. Adenoid basal carcinoma should be considered when an asymptomatic postmenopausal woman has a high grade intra-epithelial abnormality on Pap smear and colposcopy shows an endocervical canal lesion or no abnormality. It is important to recognize ABC because its good prognosis may allow less aggressive treatment than the usual forms of cervical cancer.