ArticleInternational journal of surgery case reports2026
Adenosquamous carcinoma of the cervix: a case report from a resource-limited setting.
Article in International journal of surgery case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction and importance: Adenosquamous carcinoma of the cervix (ASCC) is a rare, aggressive histological variant representing 1.8% to 5% of cervical malignancies. It is generally associated with a poorer prognosis than squamous cell carcinoma. In resource-limited settings, systemic barriers often preclude standardized multimodal management, necessitating management decisions shaped by limited resources. This case is presented following the SCARE criteria. Case presentation: A 64-year-old multiparous female presented to a tertiary hospital in Uganda with a multi-month history of dyspareunia and post-coital bleeding. Physical examination revealed an ulcerated cervical lesion; however, HPV DNA screening was unavailable. The patient underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathology revealed a 3.0 cm mass with dual squamous and glandular differentiation, staged as pT1b1 Nx Mx according to the AJCC eighth edition. Due to a lack of equipment, radical lymphadenectomy and adjuvant radiotherapy were not performed. A 5-year surveillance plan was proposed for postoperative follow-up. Clinical discussion: This case highlights the gap between basic care and enhanced international standards for cervical malignancies in women. The Nx status reflects incomplete nodal staging in a resource-limited setting. Lack of equipment limited the ability to provide appropriate, screening-based surgical management, making prospective postoperative surveillance necessary. Conclusion: ASCC necessitates early detection and standardized multimodal care, objectives that are frequently precluded by infrastructure constraints in Sub-Saharan Africa. Improving outcomes for such aggressive histologies requires a concerted global effort to expand access to HPV vaccination, DNA-based screening, and equitable radiotherapy infrastructure. This may improve the likelihood of curative treatment in resource-constrained environments.
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