Minimal deviation adenocarcinoma and its mimickers: a case report with review of literature
Keywords:
Minimal deviation adenocarcinoma, tunnel clusters, lobular endocervical hyperplasia, endocervicosis, florid deep glands, Immunohistochemistry.
Abstract
Amongst all the glandular lesions of the cervix, minimal deviation adenocarcinoma (MDA) the, so called Adenoma-malignum and its mimickers have been the subject of great interest in the literature. Although a rare entity, MDA commonly requires consultancy to distinguish it from many benign cervical glandular lesions.MDA is a unique neoplasm of the uterine cervix, characterized by mucinous glands with deceptively benign histological appearance posing difficulty in its diagnosis.In the present case report MDA was an incidental finding in a 45 year old female, on the hysterectomy specimen submitted for multiple leiomyomas, and the diagnosis was based on histopathological and immunohistochemical (IHC) findings.References
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2. Kudo R, Sagae S, Kusanagi T, Mizuuchi H, Hayakawa O, Hashimoto M. Minimal-deviation adenocarcinoma (adenoma malignum) of the uterine cervix; four case reports. Eur J Obstet Gynecol Reprod Biol. 1990;34:179-88.
3. Nucci MR, Clement PB, Young RH. Lobular endocervical glandular hyperplasia, not otherwise specified: a clinicopathologic analysis of thirteen cases of a distinctive pseudoneoplastic lesion and comparison with fourteen cases of adenoma malignum. Am J Surg Pathol. 1999;23:886-91.
4. Young RH, Clement PB Endocervicosis involving the uterine cervix: a report of four cases of a benign process that may be confused with deeply invasive endocervical adenocarcinoma. Int J Gynecol Pathol. 2000;19:322-8.
5. Kaminski PF, Norris HJ Minimal deviation carcinoma (adenoma malignum) of the cervix. Int J Gynecol Pathol. 1983;2:141-52.
6. Gilks CB, Young RH, Aguirre P, DeLellis RA, Scully RE. Adenoma malignum (minimal deviation adenocarcinoma) of the uterine cervix. A clinicopathological and immunohistochemical analysis of 26 cases. Am J Surg Pathol.1989;13:717-29.
7. Young RH, Clement PB. Endocervical adenocarcinoma and its variants: their morphology and differential diagnosis. Histopathology. 2002;41:185-207.
8. Nucci MR. Pseudoneoplastic glandular lesions of the uterine cervix: a selective review. Int J Gynecol Pathol. 2014;33:330-8.
9. Matsubara A, Sekine S, Ogawa R, Yoshida M, Kasamatsu T, Tsuda H, et al. Lobular endocervical glandular hyperplasia is a neoplastic entity with frequent activating GNAS mutation. Am J Surg Pathol. 2014;38:370-6.
10. Daya D, Young RH. Florid deep glands of the uterine cervix. Another mimic of adenoma malignum. Am J Clin Pathol. 1995;103:614-7.
11. Richard J Zaino. Glandular Lesions of the Uterine Cervix . Mod Pathol 2000;13:261–274.
12. Zhu L, Yi X, Lin B, Gao A, Zhao W, Zhang Y, et al. A clinicopathological and immunohistochemical study of minimal deviation adenocarcinoma of the uterine cervix. Med Hypotheses. 2013;80:643-8.
13. An HJ, Kim KR, Kim IS, Kim DW, Park MH, Park IA, et al. Prevalence of human papillomavirus DNA in various histological subtypes of cervical adenocarcinoma: a population-based study. Mod Pathol. 2005;18:528-34.
14. Kwon SY, Choe MS, Lee HW, Lee HJ, Shin SJ, Cho CH. Minimal deviation adenocarcinoma of the cervix and tumorlets of sex-cord stromal tumor with annular tubules of the ovary in Peutz-Jeghers syndrome. J Gynecol Oncol. 2013;24:92-5.
15. McGowan L, Young RH, Scully RE. Peutz-Jeghers syndrome with ‘adenoma malignum’ of the cervix. A report of two cases. Gynecol Oncol. 1980;10:125–133
16. Mikami Y, Kiyokawa T, Hata S, Fujiwara K, Moriya T, Sasano H, et al. Gastrointestinal immunophenotype in adenocarcinomas of the uterine cervix and related glandular lesions: a possible link between lobular endocervical glandular hyperplasia/pyloric gland metaplasia and 'adenoma malignum'. Mod Pathol. 2004;17:962-72.
17. Hata S, Mikami Y, Manabe T. Diagnostic significance of endocervical glandular cells with "golden-yellow" mucin on Pap smear. Diagn Cytopathol 2002;27:80–4.
18. Sugihara T, Nakagawa S, Sasajima Y, Matsumoto Y, Takeshita S, Ayabe T. Case of minimal deviation adenocarcinoma: Possible clinical link to lobular endocervical glandular hyperplasia as its origin. J Obstet Gynaecol Res. 2014;26. doi: 10.1111/jog.12538. [Epub ahead of print].
19. Itoh K, Toki T, Shiohara S, Oguchi O, Konishi I, Fujii S. A comparative analysis of cross sectional imaging techniques in minimal deviation adenocarcinoma of the uterine cervix. BJOG 2000;107:1158–63.
2. Kudo R, Sagae S, Kusanagi T, Mizuuchi H, Hayakawa O, Hashimoto M. Minimal-deviation adenocarcinoma (adenoma malignum) of the uterine cervix; four case reports. Eur J Obstet Gynecol Reprod Biol. 1990;34:179-88.
3. Nucci MR, Clement PB, Young RH. Lobular endocervical glandular hyperplasia, not otherwise specified: a clinicopathologic analysis of thirteen cases of a distinctive pseudoneoplastic lesion and comparison with fourteen cases of adenoma malignum. Am J Surg Pathol. 1999;23:886-91.
4. Young RH, Clement PB Endocervicosis involving the uterine cervix: a report of four cases of a benign process that may be confused with deeply invasive endocervical adenocarcinoma. Int J Gynecol Pathol. 2000;19:322-8.
5. Kaminski PF, Norris HJ Minimal deviation carcinoma (adenoma malignum) of the cervix. Int J Gynecol Pathol. 1983;2:141-52.
6. Gilks CB, Young RH, Aguirre P, DeLellis RA, Scully RE. Adenoma malignum (minimal deviation adenocarcinoma) of the uterine cervix. A clinicopathological and immunohistochemical analysis of 26 cases. Am J Surg Pathol.1989;13:717-29.
7. Young RH, Clement PB. Endocervical adenocarcinoma and its variants: their morphology and differential diagnosis. Histopathology. 2002;41:185-207.
8. Nucci MR. Pseudoneoplastic glandular lesions of the uterine cervix: a selective review. Int J Gynecol Pathol. 2014;33:330-8.
9. Matsubara A, Sekine S, Ogawa R, Yoshida M, Kasamatsu T, Tsuda H, et al. Lobular endocervical glandular hyperplasia is a neoplastic entity with frequent activating GNAS mutation. Am J Surg Pathol. 2014;38:370-6.
10. Daya D, Young RH. Florid deep glands of the uterine cervix. Another mimic of adenoma malignum. Am J Clin Pathol. 1995;103:614-7.
11. Richard J Zaino. Glandular Lesions of the Uterine Cervix . Mod Pathol 2000;13:261–274.
12. Zhu L, Yi X, Lin B, Gao A, Zhao W, Zhang Y, et al. A clinicopathological and immunohistochemical study of minimal deviation adenocarcinoma of the uterine cervix. Med Hypotheses. 2013;80:643-8.
13. An HJ, Kim KR, Kim IS, Kim DW, Park MH, Park IA, et al. Prevalence of human papillomavirus DNA in various histological subtypes of cervical adenocarcinoma: a population-based study. Mod Pathol. 2005;18:528-34.
14. Kwon SY, Choe MS, Lee HW, Lee HJ, Shin SJ, Cho CH. Minimal deviation adenocarcinoma of the cervix and tumorlets of sex-cord stromal tumor with annular tubules of the ovary in Peutz-Jeghers syndrome. J Gynecol Oncol. 2013;24:92-5.
15. McGowan L, Young RH, Scully RE. Peutz-Jeghers syndrome with ‘adenoma malignum’ of the cervix. A report of two cases. Gynecol Oncol. 1980;10:125–133
16. Mikami Y, Kiyokawa T, Hata S, Fujiwara K, Moriya T, Sasano H, et al. Gastrointestinal immunophenotype in adenocarcinomas of the uterine cervix and related glandular lesions: a possible link between lobular endocervical glandular hyperplasia/pyloric gland metaplasia and 'adenoma malignum'. Mod Pathol. 2004;17:962-72.
17. Hata S, Mikami Y, Manabe T. Diagnostic significance of endocervical glandular cells with "golden-yellow" mucin on Pap smear. Diagn Cytopathol 2002;27:80–4.
18. Sugihara T, Nakagawa S, Sasajima Y, Matsumoto Y, Takeshita S, Ayabe T. Case of minimal deviation adenocarcinoma: Possible clinical link to lobular endocervical glandular hyperplasia as its origin. J Obstet Gynaecol Res. 2014;26. doi: 10.1111/jog.12538. [Epub ahead of print].
19. Itoh K, Toki T, Shiohara S, Oguchi O, Konishi I, Fujii S. A comparative analysis of cross sectional imaging techniques in minimal deviation adenocarcinoma of the uterine cervix. BJOG 2000;107:1158–63.
Published
2015-05-10
Issue
Section
Case Report
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