The histomorphologic spectrum of endocervical (Müllerian) adenocarcinoma--a potential prognostic indicator

A review of all patients with endocervical adenocarcinoma seen at the Universtiy of Kentucky Medical Center from 1962 through 1972 yielded 15 patients with tissue-verifiable primary endocervical adenocarcinoma that had no associated sarcomatous or squamoid features. These patients varied from 17 to 73 years old with a mean age of 47 years. A malignant clear cell pattern was present in 8 patients and in 3 of these individuals that prominent morphologic feature was associated with hobnail cells. Five patients with clear cell carcinomatous changes in the endocervix were born prior to the use of diethylstilbestrol (DES) and 2 of the remaining 3 patients were exposed to DES during the first trimester of pregnancy. Other morphologic types of endocervical adenocarcinoma included mucinous adenocarcinoma in 9 patients (60%) and basaloid adenocarcinoma in one patient (7%). Cellular atypia of endocervical glands, which in some areas was consistent with adenocarcinoma in situ was found in 9 of the 15 patients with invasive endocervical cancers. Both vessel invasion by tumor cells and tumor necrosis were associated with a poor prognosis.