Regarding adenocarcinoma in situ, all are true, except:
Ans. D. Negative margins on excised specimen ensures complete resection of the disease.a. Adenocarcinoma in situ of the uterine cervix is a premalignant glandular condition. Adenocarcinoma in situ is the only known precursor to cervical adenocarcinoma, and appropriate management can prevent the occurrence of invasive disease in many cases. The usual interval between clinically detectable adenocarcinoma in situ and early invasion appears to be at least five years, suggesting ample opportunity for screening and intervention.b. Glandular neoplasia of the uterine cervix is less common than squamous neoplasia, comprising one quarter of all annual cervical cancers diagnoses in the United States. Over the past few decades, however, the incidence of adenocarcinoma in situ and invasive adenocarcinoma has increased.c. Treatment for CIN 1, which is mild dysplasia, is not recommended if it lasts fewer than 2 years. Usually when a biopsy detects CIN 1 the woman has an HPV infection which may clear on its own within 12 months, and thus it is instead followed for later testing rather than treated.d. Treatment for higher grade CIN involves removal or destruction of the neoplastic cervical cells by cryocautery, electrocautery, laser cautery, loop electrical excision procedure (LEEP), or conization. Surgical treatment of CIN lesions is associated with an increased risk of infertility or subfertility, with an odds ratio of approximately 2 according to a case-control study.e. The treatment of CIN during pregnancy increases the risk of premature birth.
Invasive cancer cannot be ruled out without diagnostic excisional procedures
Hysterectomy is preferred for women who have completed childbearing
Frequently extends into the endocervical canal
Negative margins on excised specimen ensures complete resection of the disease.
Miscellaneous (Obs)