{"paper_id":"0b84afea-7f56-4aac-8cc6-255b7705fbf8","body_text":"Abstract\nEndometrial cancer arising in adenomyosis (EC-AIA), i.e., malignant transformation of the endometrium within adenomyotic foci, is a very unusual condition. We report a postmenopausal woman who had an unexpected diagnosis of uterine serous carcinoma (USC) arising from adenomyosis. A 55-year-old woman complained of anorexia with weight loss and mild abdominal pain. Pelvic cystic masses were shown by computed tomography (CT). CA125 in serum was 44.86 u/ml. Ultrasound detected a 50 × 36 mm subserous cystic-solid mass. It was misdiagnosed as a subserous uterine fibroid with cystic degeneration. The postoperative histopathological diagnosis was USC. This is the first time to discuss the ultrasound diagnosis of EC-AIA. The de novo cystic area in adenomyosis in postmenopausal women may indicate malignant transformation. Ultrasound is the first imaging choice for gynecological masses. Presenting the ultrasound image and identifying the factors that may contribute to misdiagnosis can help raise the examiner’s attention to this condition and inform the diagnostic workup in the future.\nSimilar content being viewed by others\nData availability\nData sharing does not apply to this article, as no datasets were generated or analysed during the current study.\nReferences\nBogani G, Ray-Coquard I, Concin N et al (2021) Uterine serous carcinoma. Gynecol Oncol 162:226–234\nKok VC, Tsai HJ, Su CF et al (2015) The risks for ovarian, endometrial, breast, colorectal, and other cancers in women with newly diagnosed endometriosis or adenomyosis: a population-based study. Int J Gynecol Cancer 25(6):968–976\nHi C, Rosenthal Ah (1959) Carcinoma developing in areas of adenomyosis. Obstet Gynecol 14:342–348\nRaffone A, Raimondo D, Maletta M et al (2023) Endometrial cancer arising in adenomyosis (EC-AIA): a systematic review. Cancers (Basel) 15:1142\nJha P, Ansari C, Coakley FV et al (2009) Case report: imaging of Mullerian adenosarcoma arising in adenomyosis. Clin Radiol 64(6):645–648\nHeo SH, Lee KH, Kim JW et al (2011) Unusual manifestation of endometrioid adenocarcinoma arising from subserosal cystic adenomyosis of the uterus: emphasis on MRI and positron emission tomography CT findings. Br J Radiol 84(1007):e210–e212\nIzumi Y, Yamamoto T, Matsunaga N et al (2020) Endometrial cancer arising from adenomyosis: case report and literature review of MRI findings. Radiol Case Rep 15:427–430\nLiu CH, Chang WH, Liu WM, Wang PH (2017) Serous carcinoma arising from adenomyosis. Taiwan J Obstet Gynecol 56:706–707\nOhta Y, Hamatani S, Suzuki T et al (2008) Clear cell adenocarcinoma arising from a giant cystic adenomyosis: a case report with immunohistochemical analysis of laminin-5 gamma2 chain and p53 overexpression. Pathol Res Pract 204:677–682\nBaba A, Yamazoe S, Dogru M et al (2016) Clear cell adenocarcinoma arising from adenomyotic cyst: a case report and literature review. J Obstet Gynaecol Res 42(2):217–223\nHarmsen MJ, Van den Bosch T, de Leeuw RA, Dueholm M, Exacoustos C, Valentin L, Hehenkamp WJK, Groenman F, De Bruyn C, Rasmussen C, Lazzeri L, Jokubkiene L, Jurkovic D, Naftalin J, Tellum T, Bourne T, Timmerman D, Huirne JAF (2022) Consensus on revised definitions of morphological uterus sonographic assessment (MUSA) features of adenomyosis: results of modified delphi procedure. Ultrasound Obstet Gynecol 60(1):118–131. https://doi.org/10.1002/uog.24786.PMID:34587658;PMCID:PMC9328356\nAcknowledgements\nNot applicable.\nFunding\nHunan Provincial Natural Science Foundation, 2024JJ9192, Baihua Zhao\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nConflict of interest\nAll authors declare no conflict of interest.\nEthical approval\nThis report was approved by the Medical Ethics Committee of the Second Xiangya Hospital (2023-0312). The patient provided her written informed consent.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nYang, Y., Chen, Y., Wang, Y. et al. Uterine serous carcinoma arising in adenomyosis: a case report. J Ultrasound (2025). https://doi.org/10.1007/s40477-025-01096-7\nReceived:\nAccepted:\nPublished:\nVersion of record:\nDOI: https://doi.org/10.1007/s40477-025-01096-7","source_license":"public-domain-us","license_restricted":false}