Minimal deviation adenocarcinoma (MDA) of the cervix is a highly differentiated form of adenocarcinoma that presents a significant diagnostic challenge. Due to its subtle microscopic features, MDA is often mistaken for benign conditions, which confuses pathologists and complicates its diagnosis in gynecological oncology. This leads to frequent misinterpretation and some cases are mistakenly diagnosed as benign, leading to inappropriate management. Both false-positive and false-negative MDA diagnoses are common in cervical biopsies and can have serious consequences for patient treatment. Immunohistochemistry plays an important role in the accurate diagnosis of MDA. This review summarizes the key clinical and pathological features, reviews benign mimics, and explores the immunohistochemical and molecular markers that assist in the correct diagnosis of MDA.
