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Atypical Lobular Endocervical Glandular Hyperplasia and Invasive (Minimal Deviation) Adenocarcinoma of the Cervix with Gastric Differentiation


D efinition — A deceptively bland-appearing mucinous adenocarcinoma of the cervix. Atypical lobular endocervical glandular hyperplasia (ALGH) is considered a potential precursor to minimal deviation adenocarcinoma (MDA).

Clinical Features

Epidemiology

  • Uncommon.

  • Not associated with human papillomavirus (HPV).

  • Reproductive-age women; mean age at diagnosis is 42 years.

  • Associated with Peutz-Jeghers syndrome (10% to 15% of cases).

Presentation

  • Vaginal bleeding and/or discharge.

  • Firm, indurated cervix (barrel cervix).

  • Some cases are associated with ovarian mucinous carcinomas (both primary and metastatic).

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