Original ArticlesMicropapillary Cervical Adenocarcinoma A Clinicopathologic Study of 44 CasesAlvarado-Cabrero, Isabel MD, PhD*; McCluggage, W. Glenn FRCPath†; Estevez-Castro, Rafael MD‡; Pérez-Montiel, Delia MD§; Stolnicu, Simona MD, PhD∥; Ganesan, Raji MD¶; Vella, Josefa MBCh, MSc, FRCPath¶; Castro, Rosario MD#; Canedo-Matute, Javier MD**; Gomez-Cifuentes, Jessica MD††; Rivas-Lemus, Vilma M. MD‡‡; Park, Kay J. MD§§; Soslow, Robert A. MD§§; Oliva, Esther MD∥∥; Valencia-Cedillo, Raquel MD¶¶Author Information *Pathology Department, Mexican Oncology Hospital ‡Mexican Specialty Hospital, IMSS ¶¶Hospital de Oncología, CMN, SXXI, Instituto Mexicano del Seguro Social §National Cancer Institute, Mexico ∥Pathology Department, University of Medicine and Pharmacy, Tirgu Mures, Romania †Belfast Health and, Social Care Trust, Belfast ¶Birmingham Women’s and Children’s, NHS foundation Trust, Birmingham, UK #Institute for Pathology and Cytology, Dominican Republic **Anatomical Pathology and Cytology Laboratory ††University Foundation of Health Sciences, Colombia ‡‡Department of Pathology, Saint John of God Hospital, Republic of El Salvador §§Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY ∥∥Department of Pathology, Massachusetts General Hospital, Boston, MA Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Correspondence: Isabel Alvarado-Cabrero, MD, PhD, Hospital de Oncología, CMN, SXXI, Av. Cuauhtémoc # 330, Col. Doctores, Del. Cuauhtémoc, Mexico City 06720, Mexico (e-mail: [email protected]). The American Journal of Surgical Pathology: June 2019 - Volume 43 - Issue 6 - p 802-809 doi: 10.1097/PAS.0000000000001245 Buy Metrics Abstract Micropapillary adenocarcinoma has been reported as an aggressive variant of adenocarcinoma in several organs, where it is associated with poor clinical outcome. This study reports the clinicopathologic features and outcomes of cervical adenocarcinomas with a micropapillary component (micropapillary cervical adenocarcinomas); this represents the largest reported study of these neoplasms. The study comprised 44 cervical adenocarcinomas of usual (human papillomavirus–related)-type (84%), mucinous, not otherwise specified (4.5%), gastric-type (4.5%), endometrioid (4.5%), and adenosquamous carcinoma (2%). The micropapillary component comprised >50% of the neoplasm in 34 cases (77%) (group 1), and 10% to 50% in 10 cases (23%) (group 2). Lymph node metastasis was present in 41 of 44 (93%) cases and typically the nodal tumor retained a prominent micropapillary morphology. Follow-up ranged from 7 to 123 months (mean, 65.9 mo). Seventeen of 44 (38.6%) patients had no evidence of disease on follow-up, 6/44 (13.6%) were alive with disease, and 21/44 (47.7%) died of disease. There were no survival differences between group 1 and group 2. On univariate analysis, lymph node metastasis (P=0.0015), lymphovascular space invasion (P=0.002), parametrial involvement (P=0.03), and depth of stromal invasion (P=0.045) were related to tumor recurrence. On multivariate analysis, lymph node metastasis (P=0.001), and extent of lymphovascular space invasion (P=0.027) were significant independent predictors of tumor recurrence. Our study shows that a micropapillary component in cervical adenocarcinoma may be associated with aggressive behavior and that a micropapillary architecture may occur within a variety of types of cervical adenocarcinoma. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.