Clinicopathological Characteristics of Primary Ovarian Adenomyoma: A Single-institutional Experience

Abstract

Adenomyoma is a benign neoplasm composed of endometrial-type glands, specialized endometrial-type stroma, and well-formed smooth muscle bundles. This tumor typically originates within the uterus, whereas extrauterine adenomyoma is an unusual presentation. The ovary is the most common site of extrauterine adenomyoma. In this study, we describe the clinical and pathological features and immunohistochemical findings of primary ovarian adenomyoma in patients at our Institution. In addition, we provide a thorough review of previously published cases of primary ovarian adenomyoma and clarify their clinicopathological characteristics. The most common clinical presentations of ovarian adenoma were abdominopelvic pain and abnormal menstruation. Imaging features of ovarian adenomyoma varied, showing mixed solid and cystic, solid, or cystic masses. Frequently associated conditions included congenital anomalies of the urinary tract and endometriosis. Although most cases of ovarian adenomyoma exhibit benign histopathological features, we observed one case of endometrioid carcinoma arising in ovarian adenomyoma. Clinical follow-up data indicated that simple excision of the mass is curative for ovarian adenomyoma, but certain patients underwent unnecessary surgical procedures due to lack of awareness of primary ovarian adenomyoma and high index of suspicion for malignancy in patients with solid ovarian masses. Although ovarian adenomyoma is rare, awareness of this tumor type aids pathologists in making correct diagnoses and clinicians in avoiding unwarranted therapeutic procedures.

Keywords: Ovary; adenomyoma; endomyometriosis; extrauterine adenomyoma; uterus-like mass.