Histology of a cervical lesion shows extremely well-differentiated glands lined by cytologically benign mucinous epithelium infiltrating deeply into the cervical stroma, initially mistaken for normal endocervical glands. Which clinical association should be sought?

• A Peutz-Jeghers syndrome ✓
• B Lynch syndrome
• C Von Hippel-Lindau disease
• D Li-Fraumeni syndrome

Explanation

This is adenoma malignum, also called minimal deviation adenocarcinoma, a rare variant of gastric-type mucinous cervical adenocarcinoma in which architecturally malignant but cytologically bland glands mimic benign crypts. It is classically associated with Peutz-Jeghers syndrome due to STK11 mutations, and patients may present with watery vaginal discharge. Lynch syndrome is linked to endometrioid endometrial and colonic cancers, while the other syndromes have no recognised cervical adenocarcinoma association.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.