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Research ArticleClinical Studies

Stratified Mucin-producing Intraepithelial Lesions of the Cervix: Clinical Diversity of Cases and Literature Review

CHARLOTTE DELRUE, LIEVE VANWALLEGHEM, PASCALE DE PAEPE and PHILIPPE VAN TRAPPEN
Anticancer Research February 2022, 42 (2) 1175-1180; DOI: https://doi.org/10.21873/anticanres.15583
CHARLOTTE DELRUE
1University Hospital Ghent, Ghent, Belgium
2Department of Gynecology and Gynecological Oncology, AZ Sint-Jan Hospital Bruges, Bruges, Belgium
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LIEVE VANWALLEGHEM
3Department of Pathology, AZ Sint-Jan Hospital Bruges, Bruges, Belgium
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PASCALE DE PAEPE
3Department of Pathology, AZ Sint-Jan Hospital Bruges, Bruges, Belgium
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PHILIPPE VAN TRAPPEN
2Department of Gynecology and Gynecological Oncology, AZ Sint-Jan Hospital Bruges, Bruges, Belgium
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  • For correspondence: philippe.vantrappen@azsintjan.be
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Abstract

Background: This report discusses the current literature on both non-invasive and invasive SMILE ((i)SMILE) lesions of the cervix with focus on the pathology and its related clinical diversity in several cases. Currently, the knowledge on (i)SMILE is limited to single case reports and series. As a consequence, consensus guidelines regarding the management are lacking. Although there is overlap with both high grade squamous intra-epithelial lesion (HSIL) and adenocarcinoma in situ (AIS) on immunohistochemical analyses, it is recommended to treat SMILE like AIS and further excision is needed when surgical margins are positive for SMILE on conization. (i)SMILE, should be considered as a rare subtype of adenocarcinoma of the cervix, and should be treated as such. Case Report: We describe a case with a SMILE lesion undergoing a subsequent robotic hysterectomy after conization and two cases with iSMILE: one case with an early FIGO-stage 1B1 iSMILE tumor, undergoing a robotic radical hysterectomy with sentinel procedure, and one case undergoing a robotic-assisted pelvic/para-aortic lymph node staging dissection, confirming a metastatic FIGO-stage 3C2 (for primary chemo-radiotherapy treatment). Conclusion: Here, we report for the first time a few cases of (i)SMILE with different clinical presentations, their management and follow-up. Immunohistochemical characteristics are given for both primary lesions as well as the metastases.

Key Words:
  • SMILE
  • stratified mucin-producing intraepithelial tumor
  • cervical tumor
  • pathology
  • robotic
  • Received December 15, 2021.
  • Revision received January 6, 2022.
  • Accepted January 7, 2022.
  • Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 42 (2)
Anticancer Research
Vol. 42, Issue 2
February 2022
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Stratified Mucin-producing Intraepithelial Lesions of the Cervix: Clinical Diversity of Cases and Literature Review
CHARLOTTE DELRUE, LIEVE VANWALLEGHEM, PASCALE DE PAEPE, PHILIPPE VAN TRAPPEN
Anticancer Research Feb 2022, 42 (2) 1175-1180; DOI: 10.21873/anticanres.15583

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Stratified Mucin-producing Intraepithelial Lesions of the Cervix: Clinical Diversity of Cases and Literature Review
CHARLOTTE DELRUE, LIEVE VANWALLEGHEM, PASCALE DE PAEPE, PHILIPPE VAN TRAPPEN
Anticancer Research Feb 2022, 42 (2) 1175-1180; DOI: 10.21873/anticanres.15583
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Keywords

  • SMILE
  • stratified mucin-producing intraepithelial tumor
  • cervical tumor
  • pathology
  • robotic
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