A case of endometrial cancer detected incidentally after a total laparoscopic hysterectomy for adenomyosis

Kotaro Ichida, Senn Wakahashi, Shoji Nagao
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2015 · vol. 31(1) , pp. 244–248 · doi:10.5180/jsgoe.31.244 · W2688353920
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This case study describes a 45-year-old woman who was incidentally diagnosed with endometrioid adenocarcinoma G2 after a hysterectomy for presumed adenomyosis, requiring further lymphadenectomy and adjuvant chemotherapy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This paper is a case report of a 45-year-old woman who was referred for hypermenorrhea, abnormal genital bleeding, and anemia and was evaluated with cytology, histology, MRI, and pelvic ultrasonography. Although preoperative examinations showed no malignancy and the imaging suggested an indistinct lesion in the posterior uterine wall, she underwent total laparoscopic hysterectomy with bilateral salpingo-oophorectomy under a preoperative diagnosis of adenomyosis. Histopathology revealed endometrioid adenocarcinoma G2, prompting CT/PET-CT and subsequent pelvic/para-aortic lymphadenectomy 61 days later after para-aortic lymph node swelling; metastasis was found in 11 lymph nodes, followed by adjuvant chemotherapy with no recurrence at 1 year after the second surgery. This paper is centrally about endometriosis and adenomyosis — it documents an endometrial cancer incidentally detected after surgery performed for presumed adenomyosis.

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Abstract

We present a case of endometrial cancer detected incidentally after a total laparoscopic hysterectomy for adenomyosis. A 45-year-old woman was referred to our department with the chief complaint of hypermenorrhea, abnormal genital bleeding, and anemia. Cytological and histological examinations of the uterus showed no evidence of malignancy. Magnetic resonance imaging and pelvic ultrasonography revealed an indistinct tumor in the posterior wall of the uterus. We made a diagnosis of adenomyosis and performed total laparoscopic hysterectomy with bilateral salpingo-oophorectomy. The histopathological findings revealed that it was an endometrioid adenocarcinoma G2. We additionally performed computed tomography (CT)/positron emission tomography CT and found swelling of a para-aortic lymph node. Therefore, she underwent a pelvic/para-aortic lymphadenectomy via an abdominal operation 61 days after the initial operation. The cancer had spread to 11 lymph nodes. Then, she received adjuvant chemotherapy. We found no evidence of recurrence 1 year after the second surgery.
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症例報告 子宮腺筋症の術前診断で腹腔鏡下子宮全摘出術を施行し子宮体癌と判明した1例 2015 年 31 巻 1 号 p. 244-248 詳細 抄録 We present a case of endometrial cancer detected incidentally after a total laparoscopic hysterectomy for adenomyosis. A 45-year-old woman was referred to our department with the chief complaint of hypermenorrhea, abnormal genital bleeding, and anemia. Cytological and histological examinations of the uterus showed no evidence of malignancy. Magnetic resonance imaging and pelvic ultrasonography revealed an indistinct tumor in the posterior wall of the uterus. We made a diagnosis of adenomyosis and performed total laparoscopic hysterectomy with bilateral salpingo-oophorectomy. The histopathological findings revealed that it was an endometrioid adenocarcinoma G2. We additionally performed computed tomography (CT)/positron emission tomography CT and found swelling of a para-aortic lymph node. Therefore, she underwent a pelvic/para-aortic lymphadenectomy via an abdominal operation 61 days after the initial operation. The cancer had spread to 11 lymph nodes. Then, she received adjuvant chemotherapy. We found no evidence of recurrence 1 year after the second surgery. © 2015 日本産科婦人科内視鏡学会

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adenomyosis

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