A CLINICOCYTOPATHOLOGIC STUDY OF ADENOMA MALIGNUM OF THE UTERINE CERVIX

Objectives. To investigate the nature and the clinical course of adeno ma malignum (the so-called minimal deviation adenocarcinoma) of the ut erine cervix by conducting a retrospective study of 6 cases consecutiv ely treated in a single institute. Methods. The pathologic classificat ion of adenoma malignum was performed according to the WHO classificat ion (1994). Results, These tumors accounted for only 1.32% (6/453) of invasive cervical adenocarcinomas, All the cases showed either a water y discharge or atypical genital bleeding, or both, at the time of diag nosis. The preoperative cytologic diagnosis of adenoma malignum was ma de in 83.3% (5/6) of cases. The preoperative punch biopsy, on the othe r hand, failed to confirm the diagnosis of adenoma malignum in all cas es, 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 th at cytologic examination is a potent screening method to detect this r are disease. When the presence of this disease is suspected by the cyt ologic examination, a deep biopsy is necessary to make an accurate dia gnosis. An ordinary cervical biopsy is usually insufficient to detect deeply positioned tumor glands. The prognosis of the disease may be be tter than that for ordinary cervical adenocarcinoma. (C) 1998 Academic Press.