MRI and Transvaginal Ultrasound Findings of Atypical Polypoid Adenomyoma: A Case Report / 中国医学科学杂志(英文版)

Atypical polypoid adenomyoma (APA) is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands. It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal bleeding. In our current case, a 76-year-old woman presented with irregular vaginal bleeding. The final pathological diagnosis of the mass was APA. APA is not easy to diagnose before surgery. On the one hand, there was no obvious particularity in imaging features and clinical features, especially for uncomfortably identifying endometrial cancer. On the other hand, APA has a pedicle, attaching to any part of the uterine cavity, which can cause pseudocoel between the mass with the uterine cavity wall. So, when it comes to getting the pathological tissue in the absence of hysteroscopy, it is easy to access to the pseudocoel and obtain endometrial tissue rather than the pathological tissue of the mass. Therefore, preoperative imaging examination is of great significance diagnosis way of thinking to clinicians for APA. In the meantime, pathological tissue of APA can be obtained by hysteroscopy in visual conditions.

A case of atypical polypoid adenomyoma of the uterus in a postmenopausal woman / 부인종양

Atypical polypoid adenomyoma of the uterus is a rare tumor and usually occurs in young women. The most common symptom is abnomal uterine bleeding and the definite diagnosis of the lesions depends on microscopic features. The treatment of this tumor depends on the age of the patient, her desire to retain reproductive function, and the severity of her symptoms. If the patient desires to preserve her reproductive capacity, repeated dilatations and curettages must be done because of the possibility of coexisting endometrial carcinoma. If not, hysterectomy is acceptable. We experienced a rare case of atypical polypoid adenomyoma of the uterus in a postmenopausal woman and report it with brief review of literature.

Atypical Polypoid Adenomyomas of the Endometrium: 2 case reports

Atypical polypoid adenomyoma(APA) is a rare benign polypoid tumor arising in the uterine endometrium which was first designated by Mazur in 1981. Microscopic examination reveals architecturally and cytologically atypical endometrial glands separated by intersecting fascicles of smooth muscle cells. The tumor can be misdiagnosed as endometrial adenocarcinoma with myometrial invasion, especially on microscopic examination of a curettage specimen. However a granulation tissue-like stromal response is absent and the smooth muscle in APA is more cellular than that of normal myometrium. We are reporting 2 cases of APA of the uterine endometrium which are 1.5 cm and 1.7 cm in size, respectively, in a 30 and a 22 year-old women. This is the first report in Korean literature using the immunohistochemical staining for smooth muscle actin and desmin.