Giant exophytic cystic adenomyosis with a levonorgestrel containing intrauterine device out of the uterine cavity after uterine myomectomy: A case report

Yong Zhou, Zhou Y, Chen ZY, Zheng-Yun Chen, Zhengyun Chen, Xin-Mei ZHANG, Xinmei Zhang, Zhang XM
World journal of clinical cases · 2020 · vol. 8(1) , pp. 188–193 · doi:10.12998/wjcc.v8.i1.188 · PMID:31970186 · PMC6962066 · W2997408773
article OA: diamond CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report details a giant exophytic cystic adenomyosis with a levonorgestrel-containing intrauterine device found outside the uterine cavity following a myomectomy, leading to surgical intervention.

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Abstract

BACKGROUND: A cystic lesion arising from the myometrium of the uterus, termed as cystic adenomyosis, has chocolate-like, thick viscous contents and contains various amounts of endometrial stroma below the glandular epithelium. It is an extremely rare type of adenomyosis. CASE SUMMARY: Herein, we report an unusual case of a giant cystic mass in the pelvic cavity after uterine myomectomy. The patient complained of abnormal uterine bleeding and severe dysmenorrhea. After a levonorgestrel-containing intrauterine device (LNG-IUD) was inserted, her symptoms were greatly alleviated. However, the LNG-IUD was detected in the cystic cavity during the follow-up. For fear of the intrauterine device migrating into and damaging the surrounding viscera, surgical treatment was proposed. Therefore, laparoscopic resection of the lesion and removal of the LNG-IUD were performed and cystic adenomyosis with an LNG-IUD out of the uterine cavity was diagnosed. CONCLUSION: We believe that myomectomy breaking through the endometrial cavity may have been a predisposing factor for the development of cystic adenomyosis in this case.

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Condition tags

adenomyosisdysmenorrhea

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