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Adenocarcinoma is a cervical carcinoma that appears to be increasing in frequency, though this may be an artifact of the decrease in the incidence of squamous cell carcinoma. Some cases are associated with a precursor lesion (adenocarcinoma in situ), and most of those cases are associated with HPV. This legion originates in columnar epithelium of the endocervical canal and about 15% of patients have lesions that are "hidden" from colposcopic view and from cytology sampling. Microscopically, there are a variety of patterns, but all have infiltrating, malignant, gland-forming epithelium.