Adenoma Malignum of Cervix – How Useful is Clinico- Radiological Diagnosis.

Adenoma malignum (AM) is a rare type of variant of cervical cancer. The entity remains silent because of common complaints of erratic menstrual cycles and leucorrhea in peri-menopausal age group of females. The imaging modalities play a great role in clinching the diagnosis before the final confirmation by histopathological examination. We present 60- years old post menopausal woman who reported to gynecology outpatient department with complaints of per vaginum bleeding and watery discharge of six months duration .She was evaluated by cross imaging modalities of ultrasound (US) ,color flow imaging(CFI) and magnetic resonance imaging (MRI) with working diagnosis of adenoma malignum of cervix..This was subsequently confirmed in histopathological examination. The importance of the case lies because of the early diagnosis by clinic-radiological evaluation in the light of poor prognosis and early dissemination of this entity.

Diagnostic dilemma in cervical endocervicosis

Müllerianosis is an embryonic Müllerian disease, resulting in the formation of the benign diseases adenomyosis, endometriosis, endosalpingiosis, and endocervicosis. Endocervicosis primarily affects the bladder, and rarely the cervix. Cervical endocervicosis, which is also a pseudoneoplastic glandular lesion, could be misinterpreted as a premalignant or even a malignant lesion. Because the treatment of these diseases is very different, early clinical diagnosis is important. Unfortunately, however, this lesion is difficult to diagnose preoperatively using clinical and radiological information, and pathological confirmation is needed. Herein, we report a rare case of cervical endocervicosis that was difficult to diagnosis preoperatively.

Large, Multilocular Cystic Mass in the Uterine Cervix Mimicking Adenoma Malignum / 대한폐경학회지

Multilocular cystic lesions in the uterine cervix can vary widely from benign to malignant. Pseudoneoplastic glandular lesions are benign lesions that are often histologically and radiographically confused with adenoma malignum, which is a rare variant of mucinous adenocarcinoma of the uterine cervix. The benign lesions include uterine cervicitis, tunnel cluster, deep endocervical glands, deep nabothian cysts, endocervical hyperplasia, infectious and reactive atypias. It is crucial but difficult to differentiate between an adenoma malignum and the benign cystic lesions. We report two cases of large nabothian cysts mimicking adenoma malignum. Radiologic findings, signs, and symptoms of these cases are described.

Co-occurrence of an adenoma malignum and an endocervical-type adenocarcinoma of the uterine cervix in a woman with Peutz-Jeghers syndrome / 부인종양

We report a rare co-occurrence of an adenoma malignum and an adenocarcinoma in a 30-year-old woman with Peutz-Jeghers syndrome. The woman was diagnosed with Peutz-Jeghers syndrome based on an endoscopic biopsy after vaginal bleeding. A pelvic examination and an MRI revealed the co-occurrence of a 4x5 cm protruding adenocarcinoma of FIGO stage Ib2 based on a punch biopsy and a 4.5x5.7 cm multilocular cystic mass above the solid cancer. The patient received two courses of neoadjuvant chemotherapy, followed by a laparoscopic radical hysterectomy with pelvic lymph node dissection. Pathologic findings were consistent with adenocarcinoma (40%) and adenoma malignum (60%) confined to the cervix. Three courses of adjuvant chemotherapy were performed and no clinical evidence of recurrence was seen during a 12 month follow-up period. This study will contribute to defining the best diagnosis and treatment for these rare complicating tumors.

A Case of Adenoma Malignum of the Uterine Cervix / 대한산부인과학회지

Adenoma malignum (minimal deviation adenocarcinoma) is an extremely well-differentiated adenocarcinoma of uterine cervix. Despite its benign histological appearance, this tumor is thought to be malignant and has a poor prognosis. Because Pap smear and punch biopsy have low sensitivity, accurate diagnosis of the tumor may be difficult. If it is diagnosed, it must be treated same as in cervical cancer. We presented one case of preoperatively diagnosed adenoma malignum by deep cone biposy with a brief review of literature.

A Case of Adenoma Malignum of the Uterine Cervix / 대한산부인과학회지

Adenoma malignum is a well differentiated form of adenocarcinoma. Despite of benign histologic appearance, this tumor has malignant clinical course. Because of its rarity and subtle histologic changes, it may be missed. Therefore it has poor prognosis. Early diagnosis and early treatment is required by thorough examination. We report one case of adenoma malignum of uterine cervix with a brief review of the literature.

Two Cases of Adenoma Malignum of the Uterine Cervix / 대한산부인과학회잡지

Adenoma malignum (minimal deviation adenocarcinoma) is a rare, well-differentiated form of cervical adenocarcinoma. This name is derived from the benign epithelial cell lining the glands. Despite its benign appearance, adenoma malignum have clinical malignant features. Because of its rarity and subtle histologic changes, it is quite difficult to diagnosis and may be missed. Adenoma malignum may carry a poor prognosis. We presented two cases of adenoma malignum of the uterine cervix with a brief review of related literatures.

A Case of Adenoma Malignum at the Uterine Cervix / 대한산부인과학회잡지

Adenoma Malignum (Minimal Deviation Adenocarcinoma) is a rare type well-differenciated adenocarcinoma of uterine cervix. Despite benign histologic appearance, this tumor have usually clinical malignancy. It is quite difficult to diagnosis, and the prognosis is poor. We report of this case with a brief review of literature that Adenoma Malignum was diagnosed early on transvaginal Doppler ultrasonography and MR Imaging and performed hysterectomy.

A Case of Adenoma Malignum at the Uterine Cervix / 대한산부인과학회잡지

Adenoma Malignum (Minimal Deviation Adenocarcinoma) is a rare type well-differenciated adenocarcinoma of uterine cervix. Despite benign histologic appearance, this tumor have usually clinical malignancy. It is quite difficult to diagnosis, and the prognosis is poor. We report of this case with a brief review of literature that Adenoma Malignum was diagnosed early on transvaginal Doppler ultrasonography and MR Imaging and performed hysterectomy.

Case of Adenoma Malignum of the Uterine Cervix / 대한산부인과학회잡지

Adenoma malignum (minimal deviation adenocarcinoma) is a rare, extremely well-differentiated form of invasive cervical adenocarcinoma. The name derives from the deceptively benign epithelial cells that line the glands of this neoplasm. The presence of architectural disorder with irregular, abnormally shaped invasive glands sometimes surrounded by a desmoplastic stromal response or demonstrating vascular and perineural invasion may be the only features establishing its malignant nature. Despite its bland appearance, adenoma malignum may carry a poor prognosis. Because of its rarity, and possibly because diagnostic changes are subtle and may be missed, there are few reports. A case of adenoma malignum of the uterine cervix is presented with a brief review of the literatures.

Case of Adenoma Malignum of the Uterine Cervix / 대한산부인과학회잡지

Adenoma malignum (minimal deviation adenocarcinoma) is a rare, extremely well-differentiated form of invasive cervical adenocarcinoma. The name derives from the deceptively benign epithelial cells that line the glands of this neoplasm. The presence of architectural disorder with irregular, abnormally shaped invasive glands sometimes surrounded by a desmoplastic stromal response or demonstrating vascular and perineural invasion may be the only features establishing its malignant nature. Despite its bland appearance, adenoma malignum may carry a poor prognosis. Because of its rarity, and possibly because diagnostic changes are subtle and may be missed, there are few reports. A case of adenoma malignum of the uterine cervix is presented with a brief review of the literatures.

A case of minimal deviation adenocarcinoma originated from uterine endocervix / 대한산부인과학회잡지

Minimal deviation adenocarcinoma (adenoma malignum) is a variant of adenocarcinoma and is expressed from uterine endocervix. As a result of ever reported cases in the world, it is rare enough to occur in 1 to 2% of invasive cervical adenocarcinoma. Minimal deviation adenocarcinoma is well-differentiated form of adenocarcinoma in which the cytoplasmic mucin is rich and the glandular pattern simulates that of normal endocervical glands. Because of this, the tumor may not be recognized as malignant in small specimens, thereby causing delay in diagnosis. But recent studies have found a favorable prognosis if the disease is detected early. We experienced a case of minimal deviation adenocarcinoma, rare disease in the world, so we report with a brief review of literature.

A case of minimal deviation adenocarcinoma originated from uterine endocervix / 대한산부인과학회잡지

Minimal deviation adenocarcinoma (adenoma malignum) is a variant of adenocarcinoma and is expressed from uterine endocervix. As a result of ever reported cases in the world, it is rare enough to occur in 1 to 2% of invasive cervical adenocarcinoma. Minimal deviation adenocarcinoma is well-differentiated form of adenocarcinoma in which the cytoplasmic mucin is rich and the glandular pattern simulates that of normal endocervical glands. Because of this, the tumor may not be recognized as malignant in small specimens, thereby causing delay in diagnosis. But recent studies have found a favorable prognosis if the disease is detected early. We experienced a case of minimal deviation adenocarcinoma, rare disease in the world, so we report with a brief review of literature.

A Case of Adenoma Malignum at the Uterine Cervix / 대한산부인과학회잡지

We report one case of adenoma malignum of the cervix. Adenoma malignum is an extremely well-differentiated form of adenocarcinoma in which the branching glandular pattern strongly simulates that of the normal endocervical glands. This term has been used to describe a very well-differentiated adenocarcinoma characterized histologically by distorted and architecturally irregular endocervical glands which penetrate deeply into the wall of the cervix, but with minimal and focal evidence of glandular cell stratification, anaplasia, or mitotic activity. Despite this innocuous histologic appearance, these tumors have classically been thought to be clinically highly malignant, with an almost invariably rapid lethal outcome. The diagnosis of minimal deviation adenocarcinoma (adenoma malignum) of the endocervix may be difficult. The diagnosis was adenocarcinoma on the Pap Smear treatment has been hysterectomy.

Cytologic Features of Adenoma Malignum of the Uterine Cervix: A Case Report / 대한세포병리학회지

Adenoma malignum is an extremely well-differentiated variant of cervical adeno carcinoma in which the cells composing the tumor lack the typical cytological features of malignancy. The prognosis of this rare tumor is poor in spite of high degree of differentiation. The cytologic characteristics are extremely bland, so frequently make a confusion of adenoma malignum with endocervical glandular hyperplasia. We report a case of adenoma malignum in a 36-year-old woman who complained of mucoid vaginal discharge and vaginal bleeding. The cervicovaginal smear showed endocervical cells exhibiting a spectrum of atypical changes. The cells were arranged in multilayered strips and monolayered sheets. Individual cells ranged from cuboidal to columnar; typically the columnar cells had abundant lacy or vacuolated cytoplasm. The smear showed the majority of only atypical cells and small numbers of frankly malignant cells.