The best way to evaluate unclassified AGUS is unclear. Some practitioners advocate repeat cytobrush and endometrial biopsy, but this method can miss rapidly developing adenocarcinoma. Persistent findings of AGUS that are not reconciled by other evaluations require the performance of a cone biopsy. Clinical characteristics of adenocarcinoma of the cervix. The detection of cervical adenocarcinoma and its precursors are a challenge to the clinician.
Most adenocarcinomas grow endophytically and are less likely to be detected.
It appears that HPV 18 is strongly linked to cervical adenocarcinoma, rather than HPV 16, which is strongly linked with cervical squamous cell carcinoma. In the past, hysterectomy was recommended as the treatment of choice. However, since many women with ACIS are in the childbearing years, more conservative management has been proposed. A negative conization margin was not reassuring, since ACIS is a multicentric disease. Hysterectomy may be a better option.