Clinicopathological features of well-differentiated cervical adenocarcinoma with abundant mucus secretion

Fourteen patients who had cervical adenocarcinoma with abundant mucus secretion (stages Ib: 4, IIb: 8, IIIb: 2) were reviewed. Their tumors were clearly distinguishable from the majority of cervical adenocarcinomas without abundant mucin on the basis of the clinicopathological features. The portio vaginalis featured large induration and swelling as well as showing rubber ball-like resilience. The surface of tumors showed no ulceration, necrosis, or bleeding, even in advanced cases. Colposcopy revealed large glandular openings filled with mucus. The initial smear test was negative or suspicious in 11 cases due to the abundance of mucus or slight cellular atypia. Even on biopsy findings, five cases were diagnosed as normal cervical glands. The diagnosis of cancer had been overlooked for six months to one year or more because of negative smears in six cases. The final histologic diagnosis was well-differentiated adenocarcinoma (endocervical type), including adenoma malignum and mucinous adenocarcinoma. Patients with this type of adenocarcinoma had a poor prognosis. It is important to keep in mind the distinctive clinical features of adenocarcinoma with abundant mucus secretion in order not to miss the diagnosis.