title: A clinicocytopathologic study of adenoma malignum of the uterine cervix.
abstract: OBJECTIVE
  To investigate the nature and the clinical course of adenoma malignum (the so-called minimal deviation adenocarcinoma) of the uterine cervix by conducting a retrospective study of 6 cases consecutively treated in a single institute.
  
  
  METHODS
  The pathologic classification of adenoma malignum was performed according to the WHO classification (1994).
  
  
  RESULTS
  These tumors accounted for only 1.32% (6/453) of invasive cervical adenocarcinomas. All the cases showed either a watery discharge or atypical genital bleeding, or both, at the time of diagnosis. The preoperative cytologic diagnosis of adenoma malignum was made in 83.3% (5/6) of cases. The preoperative punch biopsy, on the other hand, failed to confirm the diagnosis of adenoma malignum in all cases, although the presence of the disease was suspected in 2 cases (33%). The 5-year survival rate and 5-year disease-free survival rate were 100 and 83.3%, respectively.
  
  
  CONCLUSIONS
  This series demonstrates that cytologic examination is a potent screening method to detect this rare disease. When the presence of this disease is suspected by the cytologic examination, a deep biopsy is necessary to make an accurate diagnosis. An ordinary cervical biopsy is usually insufficient to detect deeply positioned tumor glands. The prognosis of the disease may be better than that for ordinary cervical adenocarcinoma.
authors.affiliation: Departments of Gynecology and Cytology, Department of Pathology, Cancer Institute Hospital, Cancer Institute, 1-37-1,Kami-Ikebukuro, Toshimaku, Tokyo, 170, Japan. yhirai@jfcr.or.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Hirai
authors.forename: N
authors.initials: N
authors.lastname: Takeshima
authors.forename: A
authors.initials: A
authors.lastname: Haga
authors.forename: Y
authors.initials: Y
authors.lastname: Arai
authors.forename: F
authors.initials: F
authors.lastname: Akiyama
authors.forename: K
authors.initials: K
authors.lastname: Hasumi
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology*; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000473:pathology*