Adenoma malignum: MR imaging and pathologic study.
OBJECTIVE
To evaluate the clinical, pathologic, and magnetic resonance (MR) imaging findings in adenoma malignum, a rare variant of uterine cervical adenocarcinoma.


METHODS
Medical records of all patients (n = 7) with adenoma malignum of the uterine cervix diagnosed pathologically between 1988 and 1996 were retrospectively reviewed. Unenhanced T1-weighted and T2-weighted images and gadolinium-enhanced T1-weighted MR images were evaluated, and findings were correlated with gross pathologic and microscopic features.


RESULTS
In five of seven patients, enlargement of the cervix was seen. All lesions were detected as multiple cystic lesions that extended from the endocervical gland to the deep stroma of the cervix. They appeared isointense (n = 5) or slightly hyperintense (n = 2) relative to the uterus on T1-weighted images and markedly hyperintense relative to the uterus on T2-weighted images. Solid portions of variable size were seen between cystic lesions, and both the multiple cystic component and the solid portion were most apparent on the gadolinium-enhanced T1-weighted images. Microscopic parametrial invasion was seen in two patients but was not detected at MR imaging.


CONCLUSIONS
Adenoma malignum was depicted on MR images as a multicystic mass with solid portions located in the deep cervical stroma. Gadolinium enhancement helped identify the solid portion of the tumor.
Doi
T
T
Department of Radiology, Kumamoto University School of Medicine, Honjo, Japan.
Yamashita
Y
Y
Yasunaga
T
T
Fujiyoshi
K
K
Tsunawaki
A
A
Takahashi
M
M
Katabuchi
H
H
Tanaka
N
N
Okamura
H
H
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery
D005682:Gadolinium