347 Endocervical microglandular hiperplasia in a 21 years old patient

Objectives Endocervical microglandular hiperplasia (MGH) is a reactive type of glandular lesion that may be confused with endocervical adenocarcinoma from the macroscopic and the colposcopic findings, as well as from a histological. Differential diagnosis is important. Methods Case report. Patient aged 21 years, with losses smelly and caused metrorrhagia. She has been on oral contraceptives. Examination: exuberant and friable cervix. A budding papillary lesion of the cervix circumferential. Cervix 2–3 cm in diameter, free parameters. Colposcopy with new biopsy confirming florid endocervical microglandular hyperplasia in a context of of endocervicitis. Cytology normal. Oncogenic Papillomavirus positive. Ultrasound: mixed tissue image stretching the endocervix by 35*27*14 mm surrounded by vessels but not vascularized. MRI: atypical image, ulceration. Tumor origin? In view of the very atypical aspect, we propose a conisation and endocervical curettage with a view to diagnosis. Histology of conisation: microglandular cervical hyperplasia associated with subacute and chronic cervicitis. Immunohistochemistre: p16 negative. Results Conclusions MGH incidence is about 15% and generally is found in young women. MGH seems to be associated to the effects of endogenous hormones, pregnancy or to iatrogenic effects of prolonged hormone therapy or contraceptives. But in some stuadies the association between MGH and the use of long-term of hormones is not clear beacuse it can also be found in post-menopausal women with or without a history of hormone replacement therapy. In conisation specimens normally is associated to CIN (Cervical intraepithelial neoplasia) Immunohistochemical markers like p53, CEA, MIBI and Ki67 can be useful for the differential diagnosis if histology is not clear.