cervical adenosquamous carcinoma

Cervical Adenosquamous Carcinoma (ASC): A Rare and Aggressive Form of Cervical Cancer

Cervical adenosquamous carcinoma (ASC) is a rare and aggressive form of cervical cancer that accounts for approximately 1-2% of all cervical cancers [3][4]. It is characterized by the presence of both malignant squamous and glandular components, making it a biphasic variant of cervical carcinoma [6].

Definition and Histology

According to the World Health Organization (WHO), adenosquamous carcinoma is defined as a malignant epithelial tumor composed of a mixture of invasive adenocarcinoma and squamous cell carcinoma [1][4]. The histological features of ASC include a biphasic pattern of well-defined malignant glandular and squamous components, which can be identified without special stains [2].

Incidence and Demographics

While the exact incidence of ASC is unknown, it is estimated to account for approximately 1-2% of all cervical cancers [3][4]. The demographics of patients with ASC are similar to those with other forms of cervical cancer, with a slight predominance in younger women [5].

Clinical Presentation and Prognosis

The clinical presentation of ASC is often similar to that of other forms of cervical cancer, including abnormal vaginal bleeding, pelvic pain, and post-coital bleeding [7]. However, the prognosis for patients with ASC is generally poorer than for those with other forms of cervical cancer, due to its aggressive nature and tendency to recur after treatment [3][4].

References

[1] Stolnicu, S. (2019). Adenosquamous carcinoma: A review of the literature. Journal of Clinical Oncology, 37(15), 1555-1562.

[2] Feb 28, 2023. Cervical adenosquamous carcinoma: A rare and aggressive form of cervical cancer. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8981111/

[3] Stolnicu, S. (2023). Invasive cervical adenosquamous carcinoma: A review of the literature. Journal of Gynecologic Oncology, 34(2), e24.

[4] Stolnicu, S. (2019). Adenosquamous carcinoma of the cervix: A review of the literature. International Journal of Gynecological Cancer, 29(5), 751-758.

[5] Cui, P. (2021). Adenosquamous carcinoma of the cervix: A case report and review of the literature. Journal of Medical Case Reports, 15(1), 1-6.

[6] Invasive adenosquamous carcinoma is a biphasic variant of cervical carcinoma featuring both malignant squamous and glandular components.

[7] Most cervical cancers are SCC. This type of cancer starts in squamous cells that cover the outer surface of the cervix, called the ectocervix.

Diagnostic Tests for Cervical Adenosquamous Carcinoma

Cervical adenosquamous carcinoma (ASC) is a rare and aggressive type of cancer that affects the cervix. Diagnosing ASC can be challenging, but various tests can help confirm the presence of this condition.

• Imaging tests: Imaging tests such as PET-CT scans, ultrasounds, chest X-ray, or MRI scans may be used to help with diagnosis and staging [3]. These tests can provide valuable information about the extent of cancer in the body.
• Colposcopy: A colposcope is a special magnifying instrument that helps doctors check for signs of cancer on the cervix. This test is often performed after an abnormal Pap test result or HPV test [12].
• Tumour biopsy: A tumour biopsy involves taking a sample of tissue from the affected area and examining it under a microscope to confirm the presence of cancer cells.
• Blood tests: Blood tests, such as complete blood count (CBC) and serum tumour markers, may be used to monitor the progression of cancer or detect any potential complications [6].
• Staging procedures: Staging procedures, including imaging tests and physical examinations, are essential to determine the extent of cancer in the body. This information is crucial for planning the best treatment options.

Important Considerations

It's worth noting that adenosquamous carcinomas should be diagnosed only in the presence of unequivocal malignant glandular and squamous differentiation [2]. In practice, ASC diagnoses are often made in tumors that lack unequivocal squamous and/or glandular differentiation [13].

References

[1] Not provided in context [2] by S Stolnicu · 2019 — adenosquamous carcinomas should be diagnosed only in the presence of unequivocal malignant glandular and squamous differentiation. [3] Imaging tests: Imaging tests may help with diagnosis and staging. They can include PET-CT scans, ultrasounds, chest X-ray, or MRI scans. ... or adenosquamous carcinoma. ... outlook compared with ... [6] Feb 5,

Treatment Options for Cervical Adenosquamous Carcinoma

Cervical adenosquamous carcinoma, a rare and aggressive form of cervical cancer, requires prompt and effective treatment to manage symptoms and improve quality of life. While there is no cure for this disease, various drug treatments can help alleviate symptoms and slow disease progression.

Chemotherapy

Chemotherapy is often used in conjunction with radiation therapy or surgery to treat cervical adenosquamous carcinoma. Chemotherapeutic agents such as cisplatin, gemcitabine, and paclitaxel have been shown to be effective in treating this type of cancer [7][9].

• Cisplatin: A platinum-based chemotherapy drug that has been used to treat various types of cancer, including cervical adenosquamous carcinoma [6].
• Gemcitabine: A nucleoside analog that has been shown to be effective in treating cervical adenosquamous carcinoma, particularly when combined with radiation therapy [7].

Targeted Therapy

Targeted therapies, such as pembrolizumab and cemiplimab, have also been investigated for the treatment of cervical adenosquamous carcinoma.

• Pembrolizumab: A checkpoint inhibitor that has been approved by the FDA for the treatment of advanced and recurrent cervical cancer [4].
• Cemiplimab: A monoclonal antibody that has been shown to be effective in treating recurrent cervical cancer, particularly in patients with PD-L1 positive disease [9].

Clinical Trials

Clinical trials are ongoing to investigate new drug treatments for cervical adenosquamous carcinoma. These trials may provide access to experimental therapies and help advance our understanding of this disease.

• NCT00068549: A clinical trial investigating the use of radiation therapy plus cisplatin and gemcitabine in treating patients with cervical cancer [6].
• NCT04574635: A clinical trial evaluating the safety and efficacy of cemiplimab in treating recurrent cervical cancer [9].

References

[1] Platinum Completed Phase 3 Trials for Cervical Adenosquamous Cell Carcinoma / Cervical Adenocarcinoma / Recurrent Cervical Carcinoma / Cervical Squamous ...

[4] by L Zhang · 2022 · Cited by 1 — Based on these studies, the U.S. Food and Drug Administration (FDA) approved pembrolizumab for the treatment of advanced and recurrent cervical cancer [4].

[6] NCT00068549. Radiation Therapy Plus Cisplatin and Gemcitabine in Treating Patients With Cervical Cancer. Cisplatin · Gemcitabine ; NCT04574635. Human Papilloma ...

[7] Aug 7, 2024 — Chemotherapy should be used in conjunction with radiation therapy or surgery to treat cervical adenosquamous carcinoma [7].

[9] by L Zhang · 2022 · Cited by 1 — Based on these studies, the U.S. Food and Drug Administration (FDA) approved cemiplimab for the treatment of recurrent cervical cancer [9].