[Minimal deviation endocervical adenocarcinoma--clinical, histologic and immunohistochemical study]

Minimal deviation endocervical adenocarcinoma (MDA) is a rare form of adenocarcinoma which differentiates well, grows rapidly, spreads early and has poor prognosis. In this series, 9 cases of MDA and its clinical, histologic and immunohistochemical characteristics are reported. The main clinical pictures were enlarged cervix with marked increase in vaginal discharge (7 cases) and irregular vaginal bleeding (2 cases). Histologically, this neoplasm was composed of structures almost identical to normal endocervical glandular patterns characterized by a haphazard proliferation of both large claw-shaped glands and small, slit-shaped, pointed glands which penetrated into the wall of the cervix beyond 5 mm in depth. Focal mild cytologic atypia was demonstrated in each case. Immunohistochemical stains showed focal cytoplasmic carcinoembryonic antigen (CEA) in each neoplasm. Seven of the nine patients were followed: four died of their neoplasms, one survived for more than 2 years, one for 1 year, and one was a new case. The diagnostic features and characteristics of immunohistochemistry of this cancer are described and its nomenclature, clinical manifestations and prognosis and discussed.