ADENOMA MALIGNUM - MR-IMAGING AND PATHOLOGICAL-STUDY

PURPOSE: To evaluate the clinical, pathologic, and magnetic resonance (MR) imaging findings in adenoma malignum, a rare variant of uterine c ervical adenocarcinoma. MATERIALS AND METHODS: Medical records of all patients (n = 7) with adenoma malignum of the uterine cervix diagnosed pathologically between 1988 and 1996 were retrospectively reviewed. U nenhanced T1-weighted and T2-weighted images and gadolinium-enhanced T 1-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. Al 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 im ages and markedly hyperintense relative to the uterus on T2-weighted i mages. Solid portions of variable size were seen between cystic lesion s, and both the multiple cystic component and the solid portion were m ost apparent on the gadolinium-enhanced T1-weighted images. Microscopi c parametrial invasion was seen in two patients but was not detected a t MR imaging. CONCLUSION: Adenoma malignum was depicted on MR images a s a multicystic mass with solid portions located in the deep cervical stroma. Gadolinium enhancement helped identify the solid portion of th e tumor.