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Minimal deviation mucinous adenocarcinoma of the uterine cervix that proved difficult to differentiate from endometrial cancer: A case report.

Nishii Y, Fukuda T, Imai K, Yamauchi M, Hashiguchi Y, Ichimura T, Yasui T, Sumi T - Oncol Lett (2014)

Bottom Line: Minimal deviation adenocarcinoma (MDA), also known as adenoma malignum of the uterine cervix, accounts for only ~1% of uterine cervical adenocarcinomas.Adenoma malignum of the uterine cervix was initially described by Gusserow in 1870.The patient is currently alive with the disease 10 months following the surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.

ABSTRACT
Minimal deviation adenocarcinoma (MDA), also known as adenoma malignum of the uterine cervix, accounts for only ~1% of uterine cervical adenocarcinomas. Adenoma malignum of the uterine cervix was initially described by Gusserow in 1870. Using magnetic resonance imaging (MRI), MDA appears as multilocular lesions with solid components that extend from the endocervical glands to the deep cervical stroma. Cytological evaluation and biopsies have low detection rates, therefore, it is difficult to diagnose MDA accurately prior to treatment. The current study describes a rare case of MDA that was difficult to differentiate from endometrial adenocarcinoma of the corpus uteri preoperatively, as the endometrial biopsy results suggested a well-differentiated endometrioid adenocarcinoma and MRI did not show typical images for MDA. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed under the diagnosis of endometrial cancer, and the mass was subsequently diagnosed as MDA of the uterine cervix by pathological examination of the hysterectomy specimen. Postoperatively, although two types of adjuvant chemotherapy were performed, the remaining tumor continued to grow, causing obstruction of the bilateral ureters and leading to bilateral hydronephrosis. The patient is currently alive with the disease 10 months following the surgery.

No MeSH data available.


Related in: MedlinePlus

(A) Low-power and (B) high-power view of the multicystic lesions that resemble normal endocervical glands. The majority of glands had an irregular shape, cellular atypia and structural dysplasia. Branching-shaped endocervical glands infiltrated deep into the muscle [magnification, (A) ×100 and (B) ×200.
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f4-ol-08-06-2481: (A) Low-power and (B) high-power view of the multicystic lesions that resemble normal endocervical glands. The majority of glands had an irregular shape, cellular atypia and structural dysplasia. Branching-shaped endocervical glands infiltrated deep into the muscle [magnification, (A) ×100 and (B) ×200.

Mentions: Based on the diagnosis of advanced endometrial adenocarcinoma of the corpus uteri, an abdominal total hysterectomy was performed with bilateral salpingo-oophorectomy and left supraclavicular lymph node biopsy. Intra-abdominal dissemination was observed and intraoperative peritoneal cytology was positive. The uterine cervix was extremely fragile and was damaged during the hysterectomy; therefore, the affected tissue was resected as much as possible. However, further tumors remained. Macroscopically, the uterine corpus was enlarged to goose-egg size and the tumor was located in the uterine cervix and uterine corpus. The tumor was predominantly present in the uterine cervix. The endometrial surface was moderately irregular (Fig. 3) and microscopically, deeply infiltrating mucinous adenocarcinoma, composed of well-formed glands arranged in an irregular fashion, was identified. The nuclear and architectural abnormalities were generally minimal; however, limited areas exhibited a desmoplastic stromal reaction, indicating a malignant nature (Fig. 4). A final diagnosis of MDA of the uterine cervix was determined. Extension of tumors to the uterine corpus, fallopian tubes and ovaries was identified and the left supraclavicular lymph node was positive for metastasis. The tumor was designated as pT4NXM1, according to the Union for International Cancer Control TNM classification (7th edition) (3).


Minimal deviation mucinous adenocarcinoma of the uterine cervix that proved difficult to differentiate from endometrial cancer: A case report.

Nishii Y, Fukuda T, Imai K, Yamauchi M, Hashiguchi Y, Ichimura T, Yasui T, Sumi T - Oncol Lett (2014)

(A) Low-power and (B) high-power view of the multicystic lesions that resemble normal endocervical glands. The majority of glands had an irregular shape, cellular atypia and structural dysplasia. Branching-shaped endocervical glands infiltrated deep into the muscle [magnification, (A) ×100 and (B) ×200.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214510&req=5

f4-ol-08-06-2481: (A) Low-power and (B) high-power view of the multicystic lesions that resemble normal endocervical glands. The majority of glands had an irregular shape, cellular atypia and structural dysplasia. Branching-shaped endocervical glands infiltrated deep into the muscle [magnification, (A) ×100 and (B) ×200.
Mentions: Based on the diagnosis of advanced endometrial adenocarcinoma of the corpus uteri, an abdominal total hysterectomy was performed with bilateral salpingo-oophorectomy and left supraclavicular lymph node biopsy. Intra-abdominal dissemination was observed and intraoperative peritoneal cytology was positive. The uterine cervix was extremely fragile and was damaged during the hysterectomy; therefore, the affected tissue was resected as much as possible. However, further tumors remained. Macroscopically, the uterine corpus was enlarged to goose-egg size and the tumor was located in the uterine cervix and uterine corpus. The tumor was predominantly present in the uterine cervix. The endometrial surface was moderately irregular (Fig. 3) and microscopically, deeply infiltrating mucinous adenocarcinoma, composed of well-formed glands arranged in an irregular fashion, was identified. The nuclear and architectural abnormalities were generally minimal; however, limited areas exhibited a desmoplastic stromal reaction, indicating a malignant nature (Fig. 4). A final diagnosis of MDA of the uterine cervix was determined. Extension of tumors to the uterine corpus, fallopian tubes and ovaries was identified and the left supraclavicular lymph node was positive for metastasis. The tumor was designated as pT4NXM1, according to the Union for International Cancer Control TNM classification (7th edition) (3).

Bottom Line: Minimal deviation adenocarcinoma (MDA), also known as adenoma malignum of the uterine cervix, accounts for only ~1% of uterine cervical adenocarcinomas.Adenoma malignum of the uterine cervix was initially described by Gusserow in 1870.The patient is currently alive with the disease 10 months following the surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.

ABSTRACT
Minimal deviation adenocarcinoma (MDA), also known as adenoma malignum of the uterine cervix, accounts for only ~1% of uterine cervical adenocarcinomas. Adenoma malignum of the uterine cervix was initially described by Gusserow in 1870. Using magnetic resonance imaging (MRI), MDA appears as multilocular lesions with solid components that extend from the endocervical glands to the deep cervical stroma. Cytological evaluation and biopsies have low detection rates, therefore, it is difficult to diagnose MDA accurately prior to treatment. The current study describes a rare case of MDA that was difficult to differentiate from endometrial adenocarcinoma of the corpus uteri preoperatively, as the endometrial biopsy results suggested a well-differentiated endometrioid adenocarcinoma and MRI did not show typical images for MDA. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed under the diagnosis of endometrial cancer, and the mass was subsequently diagnosed as MDA of the uterine cervix by pathological examination of the hysterectomy specimen. Postoperatively, although two types of adjuvant chemotherapy were performed, the remaining tumor continued to grow, causing obstruction of the bilateral ureters and leading to bilateral hydronephrosis. The patient is currently alive with the disease 10 months following the surgery.

No MeSH data available.


Related in: MedlinePlus