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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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.
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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.
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10-05-2015
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Jain M, Agarwal S, Malhotra S. Minimal deviation adenocarcinoma and its mimickers: a case report with review of literature. Ann of Pathol and Lab Med [Internet]. 2015 May 10 [cited 2024 Dec. 22];2(2):C89-94. Available from: http://pacificejournals.com/journal/index.php/apalm/article/view/125
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Copyright (c) 2015 Manjula Jain, Savita Agarwal, Sonal Malhotra
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