Minimal deviation adenocarcinoma

Topic Completed: 1 June 2010

Revised: 25 February 2019

Copyright: 2002-2018, PathologyOutlines.com, Inc.

PubMed search: minimal deviation adenocarcinoma

Mohamed Mokhtar Desouki, M.D., Ph.D.
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Cite this page: Desouki M. Minimal deviation adenocarcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/uterusminimaldev.html. Accessed September 17th, 2019.
Definition / general
  • Low grade (well differentiated), diffuse, infiltrative endometrioid adenocarcinoma with no / minimal stromal reaction
  • Not a WHO diagnosis
  • See also Cervix chapter
Clinical features
Case reports
  • 45 year old woman with involvement of corpus (focal), isthmus and entire cervix (Hum Pathol 2002;33:856)
  • 56 year old woman with minimal deviation mucinous adenocarcinoma ('adenoma malignum') (Pathol Int 2010;60:42)
  • Similar to conventional endometrioid adenocarcinoma
Gross description
Gross images

Images hosted on other servers:

Cervix is firm but otherwise unremarkable

Microscopic (histologic) description
  • Simple glandular growth pattern with infrequent branching
  • Scattered, deeply infiltrative glands with mild cellular and nuclear atypia and rare mitotic figures
  • Tumor cells grow along fibrovascular tissue, especially in perivascular spaces
  • Minimal to absent stromal desmoplasia
  • Typical endometrioid adenocarcinoma, when present, is usually more superficial, and separated by a transitional area with mildly atypical glands that appear to arise from adenocarcinoma component
  • FIGO grade 1 and nuclear grade 1 (Histopathology 2003;42:77)
  • Careful examination required to correctly assess tumor depth and stage
Microscopic (histologic) images

Images hosted on other servers:

Figure 6A / 6B

Cervical tumors

Cytology description
  • May have squamous metaplasia, epithelial cells incorporating neutrophils (Diagn Cytopathol 1999;21:117)

  • Cervix (adenoma malignum): irregular sheets of benign looking glandular cells with occasional clearing of cytoplasm, wispy cytoplasmic extensions or tails; slightly enlarged nuclei, conspicuous nucleoli; may have clusters of atypical glandular cells with prominent nucleoli (Diagn Cytopathol 1995;13:146)

Cytologic differential diagnosis includes::
  • Clear cell carcinoma
  • Microglandular hyperplasia
  • Diffuse laminar glandular hyperplasia
  • Tubal metaplasia
  • Well differentiated invasive or in situ adenocarcinoma
Positive stains
Negative stains
Differential diagnosis
  • Adenomyosis: numerous small cysts in enlarged and globular uterus, associated with myometrial hypertrophy and trabeculated smooth muscle; no typical adenocarcinoma, no infiltration, no atypia, no mitotic figures
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