A 31-year-old woman with Peutz-Jeghers syndrome undergoes hysterectomy for a cervical lesion that grossly appears as deeply infiltrating firm tissue, yet biopsy shows extremely well-differentiated glands lined by benign-appearing mucin-filled columnar cells with minimal atypia. Which entity is described?

• A Endometrioid adenocarcinoma of the cervix
• B Clear cell adenocarcinoma
• C Adenoid cystic carcinoma
• D Minimal deviation adenocarcinoma (adenoma malignum) ✓

Explanation

Minimal deviation adenocarcinoma, also called adenoma malignum, is a rare variant of gastric-type endocervical adenocarcinoma composed of deceptively benign, deeply infiltrating mucinous glands. It is classically associated with Peutz-Jeghers syndrome and carries a poor prognosis because diagnosis is delayed. Clear cell carcinoma is linked to in-utero DES exposure, and endometrioid type is associated with HPV 18 but lacks this deceptive well-differentiated appearance.

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.