Adenoma malignum of the cervix
Updates to Article Attributes
Adenoma malignum of the cervix (or minimal deviation carcinoma / minimal deviation adenocarcinoma) is considered a rare rare variant of cervical carcinoma. It is thought to represent ~1-3% of all cervical adenocarcinomas.
Epidemiology
It can present in a wide age group (~25-70 years) peaking at around 42 years 1.
Clinical presentation
Common presenting symptoms aremenometrorrhagia, vaginal (often watery) discharge, postmenopausal bleeding and abdominal swelling.
Pathology
It is considered a rare variant of well-differentiated mucinousadenocarcinoma of the uterine cervix. Multiple irregular lobulations of distorted glands demonstratinga "hair-pin" shape are considered a characteristic characteristic pathological feature 5.
Microscopic examination often shows glands which are irregular in size and shape and lined predominantly by mucin-containing columnar epithelial cells with basal nuclei.
Associations
Radiographic features
Pelvic ultrasound
Lesions can be multilocular cystic, multilocular cystic with solid components or predominantly solid on ultrasound. The solid lesions are usually heterogenous in echogenicity. Colour Doppler interrogation usually show moderate moderate or abundant colour content 10.
Pelvic MRI
May be seen as multiple cystic lesion containing variably sized solid portions extending extending from the endocervical gland to the deep stroma of the cervix.
Reported signal characteristics include
- T1: isointense (majority) to slightly hyperintense relative to the uterus 4
- T2: markedly hyperintense relative to the uterus 4
- T1 C+ (Gd): solid components show contrast enhancement
Treatment and prognosis
The overall prognosis has been reported to be unfavorable due to dissemination dissemination into the peritoneal cavity even at an early stage of the disease due to response to radiation and/or chemotherapy being poor.
History and etymology
It is thought to have been first described by Gusserow Gusserow in 1870 9.
Differential diagnosis
Considerations for a cystic multilocular cervical lesion (especially on MRI) include:
- pseudoneoplastic glandular lesions
-<p><strong>Adenoma malignum of the cervix</strong> (or <strong>minimal deviation carcinoma / minimal deviation adenocarcinoma</strong>) is considered a rare variant of <a href="/articles/carcinoma-of-the-cervix">cervical carcinoma</a>. It is thought to represent ~1-3% of all cervical adenocarcinomas.</p><h4>Epidemiology</h4><p>It can present in a wide age group (~25-70 years) peaking at around 42 years <sup>1</sup>.</p><h4>Clinical presentation</h4><p>Common presenting symptoms are <a href="/articles/menometrorrhagia">menometrorrhagia</a>, vaginal (often watery) discharge, <a href="/articles/post-menopausal-bleeding">postmenopausal bleeding</a> and abdominal swelling.</p><h4>Pathology</h4><p>It is considered a rare variant of well-differentiated mucinous<sup> </sup>adenocarcinoma of the uterine cervix. Multiple irregular lobulations of distorted glands demonstrating<sup> </sup>a "hair-pin" shape are considered a characteristic pathological feature <sup>5</sup>.</p><p>Microscopic examination often shows glands which are irregular in size and shape and lined predominantly by mucin-containing columnar epithelial cells with basal nuclei.</p><h5>Associations</h5><ul>- +<p><strong>Adenoma malignum of the cervix</strong> (or <strong>minimal deviation carcinoma / minimal deviation adenocarcinoma</strong>) is considered a rare variant of <a href="/articles/carcinoma-of-the-cervix">cervical carcinoma</a>. It is thought to represent ~1-3% of all cervical adenocarcinomas.</p><h4>Epidemiology</h4><p>It can present in a wide age group (~25-70 years) peaking at around 42 years <sup>1</sup>.</p><h4>Clinical presentation</h4><p>Common presenting symptoms are <a href="/articles/menometrorrhagia">menometrorrhagia</a>, vaginal (often watery) discharge, <a href="/articles/post-menopausal-bleeding">postmenopausal bleeding</a> and abdominal swelling.</p><h4>Pathology</h4><p>It is considered a rare variant of well-differentiated mucinous<sup> </sup>adenocarcinoma of the uterine cervix. Multiple irregular lobulations of distorted glands demonstrating<sup> </sup>a "hair-pin" shape are considered a characteristic pathological feature <sup>5</sup>.</p><p>Microscopic examination often shows glands which are irregular in size and shape and lined predominantly by mucin-containing columnar epithelial cells with basal nuclei.</p><h5>Associations</h5><ul>
-<a href="/articles/peutz-jeghers-syndrome-2">Peutz Jeghers syndrome</a> <sup>1,7</sup>- +<a href="/articles/peutz-jeghers-syndrome-2">Peutz-Jeghers syndrome</a> <sup>1,7</sup>
-</ul><h4>Radiographic features</h4><h5>Pelvic ultrasound</h5><p>Lesions can be multilocular cystic, multilocular cystic with solid components or predominantly solid on ultrasound. The solid lesions are usually heterogenous in echogenicity. Colour Doppler interrogation usually show moderate or abundant colour content <sup>10</sup>.</p><h5>Pelvic MRI</h5><p>May be seen as multiple cystic lesion containing variably sized solid portions extending from the endocervical gland to the deep stroma of the cervix. </p><p>Reported signal characteristics include</p><ul>- +</ul><h4>Radiographic features</h4><h5>Pelvic ultrasound</h5><p>Lesions can be multilocular cystic, multilocular cystic with solid components or predominantly solid on ultrasound. The solid lesions are usually heterogenous in echogenicity. Colour Doppler interrogation usually show moderate or abundant colour content <sup>10</sup>.</p><h5>Pelvic MRI</h5><p>May be seen as multiple cystic lesion containing variably sized solid portions extending from the endocervical gland to the deep stroma of the cervix. </p><p>Reported signal characteristics include</p><ul>
-</ul><h4>Treatment and prognosis</h4><p>The overall prognosis has been reported to be unfavorable due to dissemination into the peritoneal cavity even at an early stage of the disease due to response to radiation and/or chemotherapy being poor.</p><h4>History and etymology</h4><p>It is thought to have been first described by Gusserow in 1870<sup> 9</sup>.</p><h4>Differential diagnosis </h4><p>Considerations for a cystic multilocular cervical lesion (especially on MRI) include:</p><ul><li>pseudoneoplastic glandular lesions <ul>- +</ul><h4>Treatment and prognosis</h4><p>The overall prognosis has been reported to be unfavorable due to dissemination into the peritoneal cavity even at an early stage of the disease due to response to radiation and/or chemotherapy being poor.</p><h4>History and etymology</h4><p>It is thought to have been first described by Gusserow in 1870<sup> 9</sup>.</p><h4>Differential diagnosis </h4><p>Considerations for a cystic multilocular cervical lesion (especially on MRI) include:</p><ul><li>pseudoneoplastic glandular lesions <ul>
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