Minimal deviation
adenocarcinoma (MDA), also known as
adenoma malignum of the uterine cervix, accounts for only ~1% of uterine cervical
adenocarcinomas.
Adenoma malignum of the uterine cervix was initially described by Gusserow in 1870. Using magnetic resonance imaging (MRI), MDA appears as multilocular lesions with solid components that extend from the endocervical glands to the deep cervical stroma. Cytological evaluation and biopsies have low detection rates, therefore, it is difficult to diagnose MDA accurately prior to treatment. The current study describes a rare case of MDA that was difficult to differentiate from endometrial
adenocarcinoma of the corpus uteri preoperatively, as the endometrial biopsy results suggested a well-differentiated
endometrioid adenocarcinoma and MRI did not show typical images for MDA. A total abdominal
hysterectomy with bilateral
salpingo-oophorectomy was performed under the diagnosis of
endometrial cancer, and the mass was subsequently diagnosed as MDA of the uterine cervix by pathological examination of the
hysterectomy specimen. Postoperatively, although two types of
adjuvant chemotherapy were performed, the remaining
tumor continued to grow, causing obstruction of the bilateral ureters and leading to bilateral
hydronephrosis. The patient is currently alive with the disease 10 months following the surgery.