{"paper_id":"943faa3c-3a16-425a-8934-b1e1b4c5d9c8","body_text":"Abstract\nThere are several case reports of adenocarcinomas developing within adenomyosis. However, there is no report demonstrating the natural course from adenomyosis to adenocarcinoma. We report a patient (a 41-year-old Japanese woman) who was observed every 6 months after being diagnosed with adenomyosis at our University Hospital. Although she went through menopause at age 51, she occasionally complained subsequently of abnormal genital bleeding. Eleven years after the initial diagnosis, endometrial cytology revealed the presence of malignant cells. Pelvic magnetic resonance imaging (MRI) demonstrated replacement of the adenomyotic lesion by a poorly demarcated lesion, compared to the findings on prior MRI. Consequently, we performed a modified radical hysterectomy and pelvic lymph node dissection, under a presumptive diagnosis of adenocarcinoma arising in adenomyosis. Histological diagnosis revealed an endometrioid adenocarcinoma (G3) transformed from adenomyotic epithelium, which was classified, according to the International Federation of Gynecology and Obstetrics, as stage Ic, pT1cN0M0. In this patient, periodic MRI evaluations, in conjunction with pathological examination, identified the transformation from adenomyosis to adenocarcinoma.\nSimilar content being viewed by others\nReferences\nSeidman JD, Kjerulff KH (1996) Pathologic findings from the Maryland Women’s Health Study: practice patterns in the diagnosis of adenomyosis. Int J Gynecol Pathol 15:217–221\nKoshiyama M, Suzuki A, Ozawa M, et al. (2002) Adenocarcinoma arising from uterine adenomyosis: a report of four cases. Int J Gynecol Pathol 21:239–245\nColman HI, Rosenthal AH (1959) Carcinoma developing in areas of adenomyosis. Obset Gynecol 14:342–348\nReinhold C, Tafazoli F, Mehio A, et al. (1999) Uterine adenomyosis: endovaginal US and MR imaging features with histopathologic correlation. Radiographics 19:147–160\nReinhold C, McCarthy S, Bret PM, et al. (1996) Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. Radiology 199:51–58\nManfred R, Mirk P, Maresca G, et al. (2004) Local-regional staging of endometrial carcinoma: role of MR imaging in surgical planning. Radiology 231:372–378\nJacques SM, Lawrence WD (1990) Endometrial adenocarcinoma with vaiable-level myometrial involvement limited to adenomyosis: a clinicopathologic study of 23 cases. Gynecol Oncol 37:401–407\nKumar D, Anderson W (1958) Malignancy in endometriosis interna. J Obstet Gynaecol Br Emp 65: 435–437\nRonnett BM (2002) Endometrial carcinoma. In: Kurman RJ (editor) Blaustein’s pathology of the female genital tract, 5th edn. Springer-Verlag, New York Tokyo Berlin Heidelberg, pp 501–546\nPertschuk LP, Masood S, Simone J, et al. (1996) Estrogen receptor immunocytochemistry in endometrial carcinoma: a prognostic marker for survival. Gynecol Oncol 63:28–33\nFukuda K, Mori M, Uchiyama M, et al. (1998) Prognostic significance of progesterone receptor immunohistochemistry in endometrial carcinoma. Gynecol Oncol 69:220–225\nNiwa K, Murase T, Morishita S, et al. (1999) p53 overexpression and mutation in endometrial carcinoma: inverted relation with estrogen and progesterone receptor status. Cancer Detect Prev 23:147–154\nAuthor information\nAuthors and Affiliations\nCorresponding author\nAbout this article\nCite this article\nMotohara, K., Tashiro, H., Ohtake, H. et al. Endometrioid adenocarcinoma arising in adenomyosis: elucidation by periodic magnetic resonance imaging evaluations. Int J Clin Oncol 13, 266–270 (2008). https://doi.org/10.1007/s10147-007-0725-3\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s10147-007-0725-3","source_license":"public-domain-us","license_restricted":false}