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Composite cervical adenocarcinoma composed of adenoma malignum and gastric type adenocarcinoma (dedifferentiated adenoma malignum) in a patient with Peutz Jeghers syndrome
  1. W Glenn McCluggage1,
  2. Ian Harley2,
  3. Joseph P Houghton3,
  4. Felipe C Geyer4,
  5. Alan MacKay4,
  6. Jorge S Reis-Filho4
  1. 1Department of Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
  2. 2Gynaecological Oncology, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
  3. 3Department of Pathology, Craigavon Area Hospital, Northern Ireland, UK
  4. 4The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK
  1. Correspondence to Professor W Glenn McCluggage, Department of Pathology, Royal Group of Hospitals Trust, Grosvenor Road, Belfast BT12 6BA, Northern Ireland, UK; glenn.mccluggage{at}


An unusual cervical adenocarcinoma is reported in a 50-year-old woman with a history of Peutz Jeghers syndrome. The carcinoma contained two morphologically distinct and spatially separate components, one comprising typical well differentiated adenoma malignum and the other a moderately differentiated neoplasm, in keeping with gastric type adenocarcinoma. Both components were positive for HIK1083 and MUC6 and negative for p16, and did not contain human papillomavirus. It is believed that such a composite tumour has not been described in the literature. It is believed that the component of gastric type adenocarcinoma arose through a process of dedifferentiation within adenoma malignum and we provide circumstantial molecular evidence in support of the interpretation that both components may be clonally related in that they displayed an extra copy of chromosome 7. This raises the possibility of a relationship between these two uncommon types of cervical adenocarcinoma, both of which are thought to exhibit gastric differentiation.

  • Cervix
  • adenoma malignum
  • gastric type adenocarcinoma
  • dedifferentiation
  • histopathology

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.