Amin M S, Islam M N, Khan N A
Dr Md Sadrul Amin, Associate Professor, Department of Radiology & Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2018 Jul;27(3):654-657.
Adenoma malignum (AM) of the uterine cervix, otherwise known as minimal deviation adenocarcinoma, is a rare variant of cervical adenocarcinoma, which represents a diagnostic challenge, due to its benign-resembling histological characteristics. We present a case of 54-year-old nullipara woman presented with menorrhagia for 2 years and that had worsened over the past few months. Transabdominal ultrasound fibroid uterus with cluster of nabothian cysts was in the cervix. Subsequently MRI was done for better characterization and showed intramural myomas in the uterine body. A large ovoid mass containing multiple cystic components in the left side of cervix communicating with a tract to the cervical canal, which was consistent with features of adenoma malignum of the cervix. Then the differential diagnosis was included tunnel cluster nabothian cysts. The patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The final histopathologic diagnosis revealed adenoma malignum of the cervix and intramural myomas. Subsequently, a review of literature was performed and the results demonstrated that early diagnosis, clinical stage and surgical protocols are the main factors affecting the prognosis of AM. Close follow-up of the cases may provide more information regarding this disease and the efficacy of the available therapeutic methods.
子宫颈恶性腺瘤（AM），又称微小偏离性腺癌，是宫颈腺癌的一种罕见变体，因其组织学特征类似良性病变，故诊断颇具挑战。我们报告一例54岁未生育女性，有2年月经过多病史，且在过去几个月病情加重。经腹超声检查显示宫颈有子宫纤维瘤伴那氏囊肿簇。随后进行了MRI检查以更好地明确特征，结果显示子宫体有壁间肌瘤。宫颈左侧有一个大的卵圆形肿块，包含多个囊性成分，与宫颈管有通道相连，符合宫颈恶性腺瘤的特征。当时鉴别诊断包括隧道状那氏囊肿簇。患者接受了全腹子宫切除术及双侧输卵管卵巢切除术。最终组织病理学诊断为宫颈恶性腺瘤及壁间肌瘤。随后进行了文献回顾，结果表明早期诊断、临床分期和手术方案是影响AM预后的主要因素。对这些病例进行密切随访可能会提供更多关于该疾病及现有治疗方法疗效的信息。
