Glassy cell carcinoma of the cervix redefined

Glassy cell carcinoma of the cervix has been classically regarded as a poorly differentiated adenosquamous carcinoma, infrequently diagnosed and associated with a poor outcome regardless of the modality of therapy. The histologic characteristics associated with this lesion are also frequently encountered among undifferentiated large-cell, nonkeratinizing cervical carcinomas. In a review of all undifferentiated large-cell carcinomas of the cervix encountered at the University Hospital in Seattle, Washington, over an eight-year period, 29 cases appeared to display the characteristic histologic criteria described as typical for glassy cell carcinoma. All cases were stage Ib lesions, and 28 were treated by radical hysterectomy. The mean age was ten years younger than that of the usual patient treated at this institution with stage I carcinoma. Fourteen of these patients (45%) have developed recurrent carcinoma, and in all but one, the interval to recurrence was less than eight months. Only two have survived after second-line salvage therapy. The current survival rate among the 29 women is 55%. These observations suggest that the poor prognosis ascribed to the classically defined glassy cell carcinoma also holds true for this extended group of large-cell, undifferentiated cervical cancers that display similar histologic features and pursue a similarly aggressive clinical course.