Minimal deviation adenocarcinoma of the uterine cervix

Int J Gynaecol Obstet. 2010 Aug;110(2):89-92. doi: 10.1016/j.ijgo.2010.03.016. Epub 2010 May 10.

Abstract

Background: Precise preoperative diagnosis of minimal deviation adenocarcinoma (MDA) of the uterine cervix is often difficult because the histological features of MDA closely resemble those of normal cervical glands.

Objective: To review the developments in the diagnosis and treatment of MDA over the past 35 years.

Search strategy: We performed a meta-analysis of all case reports published in the English and Chinese languages between 1975 and 2009 that included a histopathologic diagnosis of MDA. Pooled odds ratios and 95% CIs were calculated for comparisons and analyzed.

Results: The histopathologic diagnosis of MDA remains difficult and is currently based on antigen detection by immunohistochemistry. Cytologic assessment and routine biopsy have low detection rates for MDA. Cross-sectional imaging techniques are helpful but a deep cervical biopsy or cervical conization is necessary for a definitive diagnosis. The mean survival is about 5 years for patients with stage I, 38.1 months for patients with stage II, 22.8 months for patients with stage III, and 5.4 months for patients with stage IV MDA.

Conclusion: Early diagnosis and treatment are key to improving prognosis and survival in patients with MDA.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / pathology*
  • Biopsy
  • Cervix Uteri / cytology
  • Conization*
  • Female
  • Humans
  • Immunohistochemistry
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / pathology*