Adenoacanthosis of endometrium: a clinicopathologic study in premenopausal women

Adenoacanthosis of the endometrium is a disorder characterized by glandular hyperplasia with squamous metaplasia. A clinicopathologic study was done of 10 cases, the majority of which were referred for consultation as atypical hyperplasia of adenoacanthoma. All of the patients were premenopausal and ranged in age from 19 to 45 years: they presented with abnormal bleeding or infertility. In four cases the adjacent endometrium was normal cycling endometrium; two were associated with chronic endometritis, and two were present within endometrial polyps. Three patients responded conservative therapy; in two others, hysterectomy disclosed no residual lesion. Although adenoacanthosis has certain morphologic features mimicking adenoacanthoma, it can be distinguished from this lesion by its growth pattern and cytologic features. Whether adenoacanthosis is a cancer precursor is unknown, but the potential reversibility of the lesion warrants conservative therapy, particularly in women of childbearing age.