title: Peutz-Jeghers syndrome-associated atypical mucinous proliferation of the uterine cervix: a case of minimal deviation adenocarcinoma ('adenoma malignum') in situ.
abstract: We describe a case of a non-invasive precursor of minimal deviation adenocarcinoma (MDA) of the uterine cervix, associated with Peutz-Jeghers syndrome (PJS). A 27-year-old woman, who had been followed for PJS, was referred to the gynecology clinic. Colposcopic examination demonstrated a small polypoid lesion in the transformation zone. Microscopic examination of the biopsy specimen demonstrated papillary proliferation of the mucinous epithelium with bland nuclear morphology. Conization revealed lobular endocervical glandular hyperplasia (LEGH) with distinct nuclear anaplasia, as well as papillary proliferation of the mucinous epithelium with mild to moderate nuclear abnormalities. This case suggests that the incipient phase of PJS-associated MDA is related to atypical LEGH ("MDA in situ"), and indicates the importance of early screening and surveillance by gynecologists in cases of PJS to detect cervical adenocarcinomas.
authors.affiliation: Department of Obstetrics and Gynecology, Kyoto Medical Center, Kyoto, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Ito
authors.forename: Sachiko
authors.initials: S
authors.lastname: Minamiguchi
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Mikami
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ueda
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sekiyama
authors.forename: Tetsurou
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Takakura
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000737:chemistry / Q000473:pathology*; D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D002278:Carcinoma in Situ / Q000737:chemistry / Q000473:pathology*; D049109:Cell Proliferation; D002584:Cervix Uteri / Q000737:chemistry / Q000473:pathology*; D003127:Colposcopy; D019092:Conization; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D009361:Neoplasm Invasiveness; D010580:Peutz-Jeghers Syndrome / Q000473:pathology*; D011230:Precancerous Conditions / Q000737:chemistry / Q000473:pathology*; D011237:Predictive Value of Tests; D002583:Uterine Cervical Neoplasms / Q000737:chemistry / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor