Adenoma malignum of the uterine cervix: report of four cases

Eun Young Ki,Sung Jong Lee,Jong Sup Park,Soo Young Hur,Seung Won Byun

doi:10.1186/1477-7819-11-168

Abstract

Adenoma malignum (AM) of the cervix is a rare disease and it is difficult to diagnose due to the deceptively benign appearance of the tumor cells. These lesions have mucin-rich cystic lesions and are usually situated deep in the cervix. Since AM is very rare, standard screening tests, diagnostic tools and treatments have not yet been established. Radiologically, it mimics multiple nabothian cysts as a benign-looking tumor. Histologically, AM is a well-differentiated adenocarcinoma and could be misdiagnosed as a benign lesion. These findings make a preoperative diagnosis of AM difficult and can result in surgery being performed based on a misdiagnosis. We report here on four cases of pathologically confirmed AM.

Highlights

Adenoma malignum (AM), called minimal-deviation adenocarcinoma, has been reported in the literature since Gusserow first described a very highly differentiated adenocarcinoma of the uterine cervix in 1870 [1,2]
AM exhibits an endophytic rather than exophytic growth pattern. It mimics multiple nabothian cysts as a benign-looking tumor [5,6,7]. These findings make a preoperative diagnosis of AM difficult and can result in surgery being performed based on a misdiagnosis
We report here on four cases of pathologically confirmed AM

Summary

Background

Adenoma malignum (AM), called minimal-deviation adenocarcinoma, has been reported in the literature since Gusserow first described a very highly differentiated adenocarcinoma of the uterine cervix in 1870 [1,2]. Her cervix was grossly normal in appearance except for the profuse mucoid discharge. Transvaginal sonography did not reveal any abnormal findings She underwent conization and pathologic examination of the conization specimen revealed multiple well-differentiated but irregularly shaped glands with invasion of the resection margin (Figure 1c, g and k). These findings were consistent with AM and the patient underwent a type I hysterectomy with pelvic lymph node sampling. Case 4 A 42-year-old woman who suffered profuse watery vaginal discharge for three years and amenorrhea for six months visited our hospital The patient had an uneventful postoperative course and is still alive five months after surgery without any recurrences

Findings

Discussion

Conclusions