[Clinical analysis of minimal deviation adenocarcinoma of the cervix: a report of five cases].
OBJECTIVE
The minimal deviation adeno-carcinoma (MDA) of the cervix is a rare disease. The misdiagnosis rate of this disease is relatively high and there is no standard treatment for it. This study was to evaluate clinicopathologic features, diagnosis, and treatment of MDA.


METHODS
Records of five patients with MDA treated in the Second Affiliated Hospital of Sun Yet-sen University from Jan. 1991 to Dec. 2006 were retrospectively analyzed.


RESULTS
The median age of the five patients was 47 years (range 38-59 years). The most common complaints included a large amount of watery discharge and atypical genital bleeding. Histology revealed that MDA was highly differentiated. Although the appearance of MDA glands was difficult to be distinguished from normal endocervical glands, the location of MDA glands was deeper than the lower level of normal endocervical glands. Carcinoembryonic antigen (CEA) and p53 in two patients were detected positive by immunohistochemistry. Four patients underwent surgery, among which one received surgery plus postoperative radiotherapy, and three received surgery plus postoperative chemotherapy and radiotherapy. One inoperable case received palliative radiotherapy. All cases were followed up for 6-88 month. Two patients achieved disease-free survival, one of which survived for more than five years. Three patients died of local recurrence and distant metastasis.


CONCLUSIONS
Diagnosis of MDA mainly depends on its clinical manifestations and the pathological feature that MDA glands are located deeper than the lower level of normal endocervical glands. Surgery combined with other adjunct therapy achieves good outcomes for MDA.
Chang
Jie
J
Department of Gynecological Oncology, The Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, PR China.
Zhang
Shen
S
Zhou
Hui
H
Liang
Jin-Xiao
JX
Lin
Zhong-Qiu
ZQ
D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D000328:Adult; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007150:Immunohistochemistry; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism; D002583:Uterine Cervical Neoplasms / Q000378:metabolism / Q000473:pathology / Q000628:therapy*
D002272:Carcinoembryonic Antigen; D016159:Tumor Suppressor Protein p53