Preoperative Differential Diagnosis of Minimal Deviation Adenocarcinoma and Lobular Endocervical Glandular Hyperplasia of the Uterine Cervix

Abstract

The combination of MRI, Pap smears, and gastric mucin will improve the accuracy of the preoperative diagnosis of MDA and LEGH. Patients suspected of having LEGH may need to be treated with less aggressive methods.

Magnetic Resonance Appearance of Gastric-Type Adenocarcinoma of the Uterine Cervix in Comparison With That of Usual-Type Endocervical Adenocarcinoma: A Pitfall of Newly Described Unusual Subtype of Endocervical Adenocarcinoma

“…7,11,12 These were subsequently reported as predominantly solid pattern, often associated with various-size cystic structures. 8,13 As Itoh et al mentioned, our results agree with their description that the tumor contains both solid and cystic lesions with considerable variability of mixed rate among the cases. In our study, intratumoral cyst was recognized in 12 of the 15 cases of GAS and 3 of the 12 cases of UEA.…”

“…13 Radiologically, it is well established that distinction between LEGH and MDA can be difficult on imaging because of some overlapping features. 7,13 Interestingly, LEGH presents gastric metaplasia and is currently considered to be a precursor of GAS; there are cases of coexistence of LEGH and GAS or adenocarcinoma in situ of gastric type. 4,14 This fact may explain the similarities observed on MRI.…”

Usefulness of a management protocol for patients with cervical multicystic lesions: A retrospective analysis of 94 cases and the significance of GNAS mutation

“…In order to improve diagnostic accuracy, we carried out a multicenter study during 2006–2007 15. Data were collected from patients with MDA or other related diseases in 24 institutions in Japan.…”

Gastric-Type Adenocarcinoma of the Uterine Cervix

“…Unlike high-risk HPVassociated precursor lesions such as squamous intraepithelial lesions and adenocarcinoma in situ that arise in the transformation zone of the cervix, LEGH frequently occurs in the portion of internal os, has gastric-type mucin, and may coexist with MDA or mucinous adenocarcinomas. 11,21 On MRI, LEGH shows small cysts or solid components surrounded by larger cysts and located closer to the isthmus. 21 Takatsu et al 21 reported that MDAs predominantly presented as a solid mass often associated with various-size cystic structures (80%) and that adenocarcinoma also predominantly appeared as a solid mass (60%) or as a mixture of solid and cystic parts (40%) and that both are associated with LEGH.…”

“…11,21 On MRI, LEGH shows small cysts or solid components surrounded by larger cysts and located closer to the isthmus. 21 Takatsu et al 21 reported that MDAs predominantly presented as a solid mass often associated with various-size cystic structures (80%) and that adenocarcinoma also predominantly appeared as a solid mass (60%) or as a mixture of solid and cystic parts (40%) and that both are associated with LEGH. The pathologic features of MDA include cystic spaces filled with mucin and well-differentiated endocervical glands lined by mucin-containing columnar epithelial cells, which may correlate with a multicystic mass on MRI.…”