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Adenoma Malignum
Douglas Rogers, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Minimal deviation adenocarcinoma
              • Well-differentiated gastric-type adenocarcinoma
            • Definitions

              • 10% of cervical adenocarcinomas are not HPV related
              • Gastric-type adenocarcinoma is most common non-HPV-related cervical adenocarcinoma (other types include clear cell, mesonephric)
              • Adenoma malignum is very well-differentiated form of gastric-type adenocarcinoma

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Chung SH et al: BRCA and beyond: comprehensive image-rich review of hereditary breast and gynecologic cancer syndromes. Radiographics. 40(2):306-25, 2020
                                            2. Tondo-Steele KE et al: The importance of considering a wide range of differential diagnoses forpatients presenting with complaints of urinary incontinence: a case report. Case Rep Womens Health. 26:e00191, 2020
                                            3. Kim Y et al: A rare case of gastric-type mucinous adenocarcinoma in a woman with Peutz-Jeghers syndrome. Obstet Gynecol Sci. 62(6):474-7, 2019
                                            4. Lee SH et al: Diagnostic dilemma in cervical endocervicosis. Obstet Gynecol Sci. 60(4):396-400, 2017
                                            5. Talia KL et al: The developing spectrum of gastric-type cervical glandular lesions. Pathology. 50(2):122-33, 2017
                                            6. Meserve EE et al: Peutz-Jeghers syndrome: pathobiology, pathologic manifestations, and suggestions for recommending genetic testing in pathology reports. Surg Pathol Clin. 9(2):243-68, 2016
                                            7. Karamurzin YS et al: Gastric-type endocervical adenocarcinoma: an aggressive tumor with unusual metastatic patterns and poor prognosis. Am J Surg Pathol. 39(11):1449-57, 2015
                                            8. Moon H et al: Profuse vaginal discharge may equally suggest adenoma malignum and lobular endocervical glandular hyperplasia (LEGH), but same cover, different story. J Minim Invasive Gynecol. 22(6S):S147, 2015
                                            9. Neto N et al: Do hereditary syndrome-related gynecologic cancers have any specific features? Insights Imaging. 6(5):545-52, 2015
                                            10. Mowat A et al: Adenoma malignum presenting as urinary incontinence. Int Urogynecol J. 25(9):1287-9, 2014
                                            11. Cole AJ et al: Patterns of myoinvasion in endometrial adenocarcinoma: recognition and implications. Adv Anat Pathol. 20(3):141-7, 2013
                                            12. Guo F et al: Diagnostic challenges in minimal deviation adenocarcinoma of the uterine cervix: a report of two cases and review of the literature. Mol Clin Oncol. 1(5):833-8, 2013
                                            13. Khalbuss WE et al: Cytomorphology of unusual primary tumors in the Pap test. Cytojournal. 10:17, 2013
                                            14. Ki EY et al: Adenoma malignum of the uterine cervix: report of four cases. World J Surg Oncol. 11:168, 2013
                                            15. Kwon SY et al: 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. 24(1):92-5, 2013
                                            16. McCluggage WG: New developments in endocervical glandular lesions. Histopathology. 62(1):138-60, 2013
                                            17. McCluggage WG: Premalignant lesions of the lower female genital tract: cervix, vagina and vulva. Pathology. 45(3):214-28, 2013
                                            18. McEachern J et al: Adenoma malignum detected on a trauma CT. J Radiol Case Rep. 7(4):22-8, 2013
                                            19. Park SB et al: Adenoma malignum of the uterine cervix: imaging features with clinicopathologic correlation. Acta Radiol. 54(1):113-20, 2013
                                            20. Takatsu A et al: Clonality analysis suggests that STK11 gene mutations are involved in progression of lobular endocervical glandular hyperplasia (LEGH) to minimal deviation adenocarcinoma (MDA). Virchows Arch. 462(6):645-51, 2013
                                            21. Dasgupta S et al: Adenoma malignum of the uterine cervix--an enigma. J Indian Med Assoc. 110(12):929-30, 2012
                                            22. Ito M et al: Peutz-Jeghers syndrome-associated atypical mucinous proliferation of the uterine cervix: a case of minimal deviation adenocarcinoma ('adenoma malignum') in situ. Pathol Res Pract. 208(10):623-7, 2012
                                            23. Lim KT et al: Adenoma malignum of the uterine cervix: Clinicopathologic analysis of 18 cases. Kaohsiung J Med Sci. 28(3):161-4, 2012
                                            24. Shiozawa T: [Adenoma malignum and lobular endocervical glandular hyperplasia (LEGH).] Nihon Rinsho. 70 Suppl 4:114-21, 2012
                                            25. Park SB et al: Adenoma malignum of the uterine cervix: ultrasonographic findings in 11 patients. Ultrasound Obstet Gynecol. 38(6):716-21, 2011
                                            26. Sharp HJ et al: PET/CT in a patient with adenoma malignum of the uterine cervix. Clin Nucl Med. 36(6):468-9, 2011
                                            27. Takatsu A et al: Preoperative differential diagnosis of minimal deviation adenocarcinoma and lobular endocervical glandular hyperplasia of the uterine cervix: a multicenter study of clinicopathology and magnetic resonance imaging findings. Int J Gynecol Cancer. 21(7):1287-96, 2011
                                            28. Bin Park S et al: Multilocular cystic lesions in the uterine cervix: broad spectrum of imaging features and pathologic correlation. AJR Am J Roentgenol. 195(2):517-23, 2010
                                            29. Li G et al: Minimal deviation adenocarcinoma of the uterine cervix. Int J Gynaecol Obstet. 110(2):89-92, 2010
                                            30. Sugiyama K et al: MR findings of pseudoneoplastic lesions in the uterine cervix mimicking adenoma malignum. Br J Radiol. 80(959):878-83, 2007
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Minimal deviation adenocarcinoma
                                                        • Well-differentiated gastric-type adenocarcinoma
                                                      • Definitions

                                                        • 10% of cervical adenocarcinomas are not HPV related
                                                        • Gastric-type adenocarcinoma is most common non-HPV-related cervical adenocarcinoma (other types include clear cell, mesonephric)
                                                        • Adenoma malignum is very well-differentiated form of gastric-type adenocarcinoma

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Chung SH et al: BRCA and beyond: comprehensive image-rich review of hereditary breast and gynecologic cancer syndromes. Radiographics. 40(2):306-25, 2020
                                                                                      2. Tondo-Steele KE et al: The importance of considering a wide range of differential diagnoses forpatients presenting with complaints of urinary incontinence: a case report. Case Rep Womens Health. 26:e00191, 2020
                                                                                      3. Kim Y et al: A rare case of gastric-type mucinous adenocarcinoma in a woman with Peutz-Jeghers syndrome. Obstet Gynecol Sci. 62(6):474-7, 2019
                                                                                      4. Lee SH et al: Diagnostic dilemma in cervical endocervicosis. Obstet Gynecol Sci. 60(4):396-400, 2017
                                                                                      5. Talia KL et al: The developing spectrum of gastric-type cervical glandular lesions. Pathology. 50(2):122-33, 2017
                                                                                      6. Meserve EE et al: Peutz-Jeghers syndrome: pathobiology, pathologic manifestations, and suggestions for recommending genetic testing in pathology reports. Surg Pathol Clin. 9(2):243-68, 2016
                                                                                      7. Karamurzin YS et al: Gastric-type endocervical adenocarcinoma: an aggressive tumor with unusual metastatic patterns and poor prognosis. Am J Surg Pathol. 39(11):1449-57, 2015
                                                                                      8. Moon H et al: Profuse vaginal discharge may equally suggest adenoma malignum and lobular endocervical glandular hyperplasia (LEGH), but same cover, different story. J Minim Invasive Gynecol. 22(6S):S147, 2015
                                                                                      9. Neto N et al: Do hereditary syndrome-related gynecologic cancers have any specific features? Insights Imaging. 6(5):545-52, 2015
                                                                                      10. Mowat A et al: Adenoma malignum presenting as urinary incontinence. Int Urogynecol J. 25(9):1287-9, 2014
                                                                                      11. Cole AJ et al: Patterns of myoinvasion in endometrial adenocarcinoma: recognition and implications. Adv Anat Pathol. 20(3):141-7, 2013
                                                                                      12. Guo F et al: Diagnostic challenges in minimal deviation adenocarcinoma of the uterine cervix: a report of two cases and review of the literature. Mol Clin Oncol. 1(5):833-8, 2013
                                                                                      13. Khalbuss WE et al: Cytomorphology of unusual primary tumors in the Pap test. Cytojournal. 10:17, 2013
                                                                                      14. Ki EY et al: Adenoma malignum of the uterine cervix: report of four cases. World J Surg Oncol. 11:168, 2013
                                                                                      15. Kwon SY et al: 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. 24(1):92-5, 2013
                                                                                      16. McCluggage WG: New developments in endocervical glandular lesions. Histopathology. 62(1):138-60, 2013
                                                                                      17. McCluggage WG: Premalignant lesions of the lower female genital tract: cervix, vagina and vulva. Pathology. 45(3):214-28, 2013
                                                                                      18. McEachern J et al: Adenoma malignum detected on a trauma CT. J Radiol Case Rep. 7(4):22-8, 2013
                                                                                      19. Park SB et al: Adenoma malignum of the uterine cervix: imaging features with clinicopathologic correlation. Acta Radiol. 54(1):113-20, 2013
                                                                                      20. Takatsu A et al: Clonality analysis suggests that STK11 gene mutations are involved in progression of lobular endocervical glandular hyperplasia (LEGH) to minimal deviation adenocarcinoma (MDA). Virchows Arch. 462(6):645-51, 2013
                                                                                      21. Dasgupta S et al: Adenoma malignum of the uterine cervix--an enigma. J Indian Med Assoc. 110(12):929-30, 2012
                                                                                      22. Ito M et al: Peutz-Jeghers syndrome-associated atypical mucinous proliferation of the uterine cervix: a case of minimal deviation adenocarcinoma ('adenoma malignum') in situ. Pathol Res Pract. 208(10):623-7, 2012
                                                                                      23. Lim KT et al: Adenoma malignum of the uterine cervix: Clinicopathologic analysis of 18 cases. Kaohsiung J Med Sci. 28(3):161-4, 2012
                                                                                      24. Shiozawa T: [Adenoma malignum and lobular endocervical glandular hyperplasia (LEGH).] Nihon Rinsho. 70 Suppl 4:114-21, 2012
                                                                                      25. Park SB et al: Adenoma malignum of the uterine cervix: ultrasonographic findings in 11 patients. Ultrasound Obstet Gynecol. 38(6):716-21, 2011
                                                                                      26. Sharp HJ et al: PET/CT in a patient with adenoma malignum of the uterine cervix. Clin Nucl Med. 36(6):468-9, 2011
                                                                                      27. Takatsu A et al: Preoperative differential diagnosis of minimal deviation adenocarcinoma and lobular endocervical glandular hyperplasia of the uterine cervix: a multicenter study of clinicopathology and magnetic resonance imaging findings. Int J Gynecol Cancer. 21(7):1287-96, 2011
                                                                                      28. Bin Park S et al: Multilocular cystic lesions in the uterine cervix: broad spectrum of imaging features and pathologic correlation. AJR Am J Roentgenol. 195(2):517-23, 2010
                                                                                      29. Li G et al: Minimal deviation adenocarcinoma of the uterine cervix. Int J Gynaecol Obstet. 110(2):89-92, 2010
                                                                                      30. Sugiyama K et al: MR findings of pseudoneoplastic lesions in the uterine cervix mimicking adenoma malignum. Br J Radiol. 80(959):878-83, 2007