A 48-year-old woman undergoes hysterectomy for a cervical mass. Histology shows extremely well differentiated, deeply infiltrating glands lined by cytologically bland mucin-producing cells, initially mistaken for normal glands. This variant of cervical adenocarcinoma is classically associated with:

• A Lynch syndrome
• B Cowden syndrome
• C Diethylstilbestrol exposure in utero
• D Peutz-Jeghers syndrome ✓

Explanation

This describes minimal deviation adenocarcinoma (adenoma malignum), a gastric-type cervical adenocarcinoma composed of deceptively benign-looking glands that infiltrate deeply, making preoperative diagnosis difficult. It is classically linked with Peutz-Jeghers syndrome (STK11 mutation) and is typically HPV-independent. DES exposure causes clear cell adenocarcinoma of the vagina and cervix (option C). Lynch syndrome is associated with endometrioid and mucinous tumours elsewhere, and Cowden syndrome with breast, thyroid and endometrial neoplasia.

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.