Cervical Adenocarcinoma In Situ in Young Nulliparous Patient with Persistent ASC-US and Multiple-Type HPV Infections Without HPV 16 and 18 Types-Case Report.

The most severe premalignant lesion of glandular epithelium of the cervix is adenocarcinoma in situ (AIS). In most cases it is associated with persistent human papillomavirus (HPV) infection and most often occurs in women in the fourth decade of life. In most high-income countries, primary screening has shifted to HPV testing, while cytology is used for patient triage. Even with current robust screening protocols, their sensitivity for glandular lesions remains limited. Diagnosis of AIS obtained by biopsy, brushing or curettage is confirmed by excisional methods and pathohistological verification. Therapy depends on the patient's lifestyle and reproductive age. In our case, we present a nulliparous patient with persistent ASC-US, multiple-type HPV infection without HPV 16 and 18 types, and AIS which was diagnosed after conization, follow-up and two biopsies with curettage of cervical canal. Our case report highlights limitations in detection of glandular lesions and need for caution in patients with persistent and seemingly low-grade cytological abnormalities, notably in young patients with high-risk HPV types.