Uterine serous carcinoma arising in adenomyosis: a case report

Endometrial 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. Similar content being viewed by others Data availability Data sharing does not apply to this article, as no datasets were generated or analysed during the current study.

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Not applicable. Funding Hunan Provincial Natural Science Foundation, 2024JJ9192, Baihua Zhao Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of interest All authors declare no conflict of interest. Ethical approval This report was approved by the Medical Ethics Committee of the Second Xiangya Hospital (2023-0312). The patient provided her written informed consent. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer 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. About this article Cite this article Yang, 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 Received: Accepted: Published: Version of record: DOI: https://doi.org/10.1007/s40477-025-01096-7