Cervix
Carcinoma
Adenosquamous carcinoma

Authors: Branko Perunovic, M.D., Ashwyna Sunassee, M.D. (see Authors page)
Editor: Ryan Askeland, M.D.

Revised: 3 November 2017, last major update December 2014

Copyright: (c) 2007-2017, PathologyOutlines.com, Inc.

PubMed Search: adenosquamous carcinoma [title] cervix

Cite this page: Cervix - Adenosquamous carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cervixadenosquamous.html. Accessed November 20th, 2017.
Definition / general
Etiology
Clinical features
  • Same prognosis as other cervical carcinomas when stratified by grade and stage but most cases are high grade
Case reports
Treatment
  • Radical hysterectomy and chemoradiation
  • Cisplatin based chemoradiation - overall survival now comparable to squamous cell carcinoma of cervix, although historically poorer prognosis
  • Poorer prognosis with radiation alone (Gynecol Oncol 2014;135:208, Gynecol Oncol 2014;135:462)
Microscopic (histologic) description
  • Usually defined as biphasic pattern of well defined malignant glandular and squamous components clearly identifiable without special stains
  • Glandular component usually endocervical and poorly differentiated with cytoplasmic vacuoles or luminal mucin
  • Squamous component also is poorly differentiated
  • If endometrioid call endometrioid carcinoma with squamous differentiation
Microscopic (histologic) images

Images hosted on PathOut server:

Poorly formed glands and squamous components



Images hosted on other servers:
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Well differentiated

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Signet ring type

Various images

Cytology description
  • Often not diagnosed on pap smear (Cancer Cytopathology 2004;102:210)
  • Papillary subtype (thin layer cytology):
    • High cellularity
    • Multiple small, papillary clusters of basaloid to columnar cells
    • Discernible fibrovascular cores
    • Background of loosely dispersed bland looking columnar cells and high grade squamous intraepithelial lesion
    • Scattered adenocarcinoma cells containing intracytoplasmic vacuoles (Acta Cytol 2003;47:649)
Positive stains
  • p63 (squamous component), CK7
Electron microscopy description
  • Glandular features include mucous secretory vacuoles, true lumen formation and scattered glycogen
  • Tonofilaments and secretory products
  • Note: most undifferentiated cervical carcinomas have ultrastructural features of squamous or glandular differentiation
Differential diagnosis