Background: The Pap smear and oncogenic human papillomavirus (HPV) testing are highly effective in screening for cervical cancer precursors. Cervical glandular abnormalities, however, are more difficult to detect and monitor than are squamous lesions.
Cases: We present 2 cases of premenopausal women with normal Pap smears, but oncogenic HPV infection and metrorrhagia. Biopsies revealed adenocarcinoma in situ, and cold-knife conization was performed.
Conclusion: Because glandular cancerous precursors can remain undetected by Pap screening, thorough evaluation of symptomatic patients with high-risk HPV is imperative.