Juvenile Cystic Adenomyoma vs Blind Uterine Horn: Challenges in the Diagnosis and Surgical Management

Athanasios Protopapas, Protopapas A, Αθανάσιος Πρωτόπαπας, Konstantinos Kypriotis, Kypriotis K, Ioannis Chatzipapas, Chatzipapas I, Nikolaos Kathopoulis, Sotiropoulou M, Maria Sotiropoulou, Lina Michala
Journal of pediatric and adolescent gynecology · 2020 · vol. 33(6) , pp. 735–738 · doi:10.1016/j.jpag.2020.08.010 · PMID:32827760 · W3053358077
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This paper details the diagnostic and surgical challenges encountered when distinguishing between juvenile cystic adenomyoma and a blind uterine horn.

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Abstract

BackgroundJuvenile cystic adenomyomas (JCAs) are rare uterine lesions. Differential diagnosis might be difficult. We present the case of an adolescent who was diagnosed with JCA and was managed with laparoscopic excision.CaseA 14-year-old patient with complaint of menarche with excruciating dysmenorrhea, was diagnosed using magnetic resonance imaging with a uterine anomaly consisting of a normal right hemiuterus, and a left cystic lesion with surrounding hypotense myometrium. She was managed with laparoscopic excision of the left side, and uterine reconstruction. Histology was suggestive of JCA, associated with diffuse adenomyosis. Dysmenorrhea improved considerably after surgery.Summary and conclusionDifferential diagnosis between cystic uterine lesions relies on clinical, imaging, and perioperative clues that might assist in their formal classification. Doubt might still remain in some cases.

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MeSH descriptors

Adenomyoma Gynecologic Surgical Procedures Laparoscopy Urogenital Abnormalities Uterine Neoplasms Uterus Adenomyoma Adenomyoma Adolescent Diagnosis, Differential Female Gynecologic Surgical Procedures Humans Laparoscopy Magnetic Resonance Imaging Urogenital Abnormalities Urogenital Abnormalities Uterine Neoplasms Uterine Neoplasms Uterus

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