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Ginecología y obstetricia de México

Print version ISSN 0300-9041

Abstract

DIAZ-RABASA, Beatriz et al. Gastric-type mucinous well differentiated adenocarcinoma (adenoma malignum): a diagnostic challenge. Ginecol. obstet. Méx. [online]. 2019, vol.87, n.6, pp.410-416.  Epub June 30, 2021. ISSN 0300-9041.  https://doi.org/10.24245/gom.v87i6.2948.

BACKGROUND:

Gastric-type mucinous well differentiated adenocarcinoma (adenoma malignum) is an infrequent cervical mucinous adenocarcinoma. It must be suspected if persistent hydrorrhea or vaginal bleeding are present, as well as multiple cervical cysts.

CLINICAL CASE:

A case of a 52-year-old woman with persistent hydrorrhea and vaginal bleeding. The study was completed with vaginal culture, cervical cytology and HPV (Human Papiloma Virus), colposcopy, endocervical curettage, transvaginal ultrasound, endometrial biopsy, hysteroscopy and magnetic resonance imaging. Multiple Nabothian cysts <2 cm and fluid in the uterine cavity and the endocervical canal were observed, with no other pathological findings. Due to the symptom persistence and severity, surgical treatment was decided, revealing the diagnosis of gastric-type mucinous well differentiated adenocarcinoma, stage IB2 (FIGO). Adjuvant treatment consisted in external radiotherapy and brachytherapy. After one year of follow-up, the patient did not show any sign of relapse.

CONCLUSIONS:

Reaching a pathological diagnosis prior to surgery has a crucial importance to decrease morbi-mortality. A thorough differential diagnosis including benign cervical lesions is essential.

Keywords : Cervical mucinous adenocarcinoma; Vaginal bleeding; Multiple cervical cysts; Nabothian Cyst; Differential diagnosis.

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