Spotlight on rare gynaecological cancers: Adenomal malignum of the cervix

Adenoma malignum is a rare and particularly aggressive subtype of cervical adenocarcinoma. Adenoma malignum is a rare cancer that starts in the gland cells that produce mucus. The cervix has glandular cells scattered along the lining of the passage that runs from the cervix to the uterus. Its prevalence is very low and about 1% to 3% of all cervical adenocarcinomas.

Adenoma malignum is characterised by the formation of small, crowded glands that resemble benign glands, making it challenging to distinguish from benign lesions or non-cancerous conditions on routine examination. Because it can resemble benign cysts, it can contribute to diagnostic difficulties and delays in detection.

It’s not a well understood malignancy as we see so few of them. It does not appear to be related to human papillomavirus (HPV) virus. 

Mucoid vaginal discharge or bleeding can be symptoms. It is usually diagnosed during a routine gynaecological examination or after an incidental finding following a hysterectomy performed for other reasons.

Like other types of cervical cancer, early detection is crucial for better treatment outcomes. An early referral to a gynaecological oncologist may save some time in establishing a diagnosis.

Prior to any treatment, patients will require medical imaging. For patients with adenoma malignum we suggest a pelvic MRI and a PET CT scan.

Treatment for cervical adenocarcinoma, including adenoma malignum, typically involves a combination of surgery, radiation therapy and chemotherapy, depending on the stage and extent of the cancer.

If you or someone you know has been diagnosed with adenoma malignum or a related condition, it's important to work closely with a healthcare team, including gynaecologic oncologists and other specialists, to determine the most appropriate treatment plan based on the specific characteristics of the cancer.

Being diagnosed with an aggressive, rare cancer can be a distressing process—speaking to a gynaecological oncologist will help you to be informed on how to effectively treat the disease.

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