A case of rapidly-growing atypical polypoid adenomyoma which was histologically diagnosed before operation and removed by a laparoscopic resection

Taiwan J Obstet Gynecol. 2018 Feb;57(1):115-118. doi: 10.1016/j.tjog.2017.12.019.

Abstract

Objective: Atypical polypoid adenomyoma (APAM) is an epithelial-mesenchymal mixed tumor which often develops in the uterine cavity of reproductive age women, requiring preservation of the reproductive functions. Preoperative endometrial biopsy may not yield histological diagnosis as the tumor is a solid smooth muscle tumor. The standard treatment option is a hysteroscopic resection for the diagnosis and the treatment at the same time.

Case report: We report a case of rapidly-growing APAM successfully diagnosed preoperatively via transcervical punch biopsy followed by a laparoscopic resection. The mass was relatively large, had been located in the lower segment of the uterus, and the area of contact with the muscular layers was large. It was a complete removal and no recurrence had been observed 9 months after the operation.

Conclusion: This is the first report of APAM treated by laparoscopic resection. The method may be a useful alternative when hysteroscopic surgery is inappropriate.

Keywords: Atypical polypoid adenomyoma; Conservative treatment; Laparoscopic surgery; Preoperative diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Adenomyoma / pathology*
  • Adenomyoma / surgery
  • Adult
  • Diagnosis, Differential
  • Endometrium / pathology
  • Female
  • Humans
  • Laparoscopy / methods*
  • Magnetic Resonance Imaging / methods
  • Polyps / pathology*
  • Polyps / surgery
  • Ultrasonography / methods
  • Uterine Neoplasms / pathology*
  • Uterine Neoplasms / surgery