Minimal deviation adenocarcinoma ("adenoma malignum") of the cervix: A diagnostic dilemma

Adenoma malignum is a rare variant of cervical adenocarcinoma. A woman of 26 years with complains of profuse mucoid discharge per vaginum on speculum examination per vaginum showed multiple cauliflowers like growth hanging within the introitus. Punch biopsy gave a report of endocervical glandular polyp with squamous metaplasia. On excision, the mass was found to arise from the cervix and external Os was separately identified. On histopathological examination the final diagnosis was adenoma malignum. Adenoma malignum of the uterine cervix is difficult to diagnose because of the deceptively benign appearance. To make a correct diagnosis, it is necessary to find a characteristic pathological feature such as multiple irregular lobulations of distorted glands demonstrating a ‘‘hair-pin’’ shape. Despite the presence of well-differentiated histopathological features, the prognosis of adenoma malignum is known to be poor because of early dissemination into the peritoneal cavity and early distant metastasis. Key word: Adenoma malignum (AM)