Florid Deep Glands of the Uterine Cervix: Another Mimic of Adenoma Malignum

Two cases of florid deep glands of the uterine cervix, a lesion which mimics adenoma malignum are reported. One case was misdiagnosed as adenoma malignum, and the patient was treated with adjuvant radiotherapy. In contrast to the majority of cases of adenoma malignum in which there is preoperative evidence of a cervical abnormality, the lesion described in both cases was an incidental microscopic finding in hysterectomy specimens. The architectural pattern in both these cases was strikingly similar, showing diffusely scattered endocervical glands within the endocervical stroma extending to the outer third of the cervical wall. However, the variability in size and shape of the glands, which were typically round to oval, was less than observed in adenoma malignum. Additionally, there was no cytologic atypia, which is observed focally in most cases of deeply invasive adenoma malignum. The lack of a desmoplastic stromal reaction, vascular and perineural invasion also may help distinguish florid deep glands from adenoma malignum. Finally, in both cases of florid deep glands, there was no cytoplasmic immunoreactivity for carcinoembryonic antigen, which is in contrast to what is seen in adenoma malignum.