Rationale:Gastric-type endocervical adenocarcinoma (GAS) is non-human papillomavirus-associated cervical cancer and the location of the lesions is in the cervical canal mostly.Patient concerns:Vaginal discharge is mistakenly thought to be caused by uterine fibroids. Misdiagnosis leads to disease progression.Diagnoses:Magnetic resonance imaging is an auxiliary tool and pathology is the gold standard for the diagnosis.Interventions:Surgery and supplementary radiotherapy and chemotherapy ± targeted therapy are the main treatment methods.Outcomes:GAS with high malignant degree poor prognosis and insidious development, tends to develop toward the cervical canal and is lack of specific tumor markers, so it is easy to misdiagnosis and missed diagnosis.Lessons:This case highlights the importance of improving the understanding of GAS. And when patients perform vaginal discharge, cervical canal hypertrophy, and cervical cancer screening negative, clinicians ought to be highly alert to GAS.