Adenoma malignum of the uterine cervix: Clinicopathologic analysis of 18 cases

The aim of this study was to evaluate the clinical and pathologic features of a rare tumor (adenoma malignum, AM). We retrospectively analyzed the medical records of 18 patients diagnosed with AM at a single institute between March 1992 and November 2009. The median age of the patients was 45.8 years (range 29-76 years) and the mean follow-up period was 49.2 months (range 4-168 months). A preoperative cytologic diagnosis (Papanicolaou smear) of AM was made in 22.2% (4/18) of the cases. Ten (55.6%) of the 18 patients were misdiagnosed with other benign diseases and underwent hysterectomies, which confirmed AM. Sixteen patients with AM were in the early stage (IB1, 11/18; 182, 5/18) and the other two patients were in the advanced stage. Fourteen of 18 patients (77.8%) had pure AM alone. Adjuvant therapy was administered to eight of the patients (44.4%) with AM. The recurrence rate was zero, but the disease progressed in two of the patients (11.1%), who died of the disease. The 5-year survival rate was 88.8%. A cytological diagnosis of AM based on a Papanicolaou smear is rarely made; a deep biopsy (cone biopsy or endocervical curettage) is necessary to diagnose this rare tumor preoperatively when there is any clinical suspicion of AM. Copyright (C) 2012, Elsevier Taiwan LLC. All rights reserved.