Management of uterine cystic adenomyosis by laparoscopic surgery: case report

Cheng-Zhi Zhao, Chengzhi Zhao, Bin Wang, Chunyan Zhong, Chun-Yan Zhong, Shen-Tao Lu, Shentao Lu, Lei Li, Li Lei
BMC women's health · 2021 · vol. 21(1) , pp. 263 · doi:10.1186/s12905-021-01341-1 · PMID:34210307 · W3173892702
article OA: gold CC0 ⤵ 10 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

Laparoscopic excision successfully treated a 30-year-old woman with a rare, large cystic adenomyosis lesion causing severe dysmenorrhea, with complete symptom resolution post-surgery.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This case report describes a 30-year-old woman with severe worsening dysmenorrhea for about 2 years in whom ultrasound found a well-circumscribed cystic uterine lesion (~5.5 × 4 × 5.0 cm) separated from the uterine cavity, with a slightly elevated CA-125 level. The authors performed laparoscopic surgery to excise adenomyotic tissue without penetrating the uterine cavity; histopathology confirmed cystic adenomyosis by demonstrating endometrial glands lining the cyst wall and macrophages with hemosiderin on the inner wall. Postoperatively, the patient received three cycles of a GnRH analogue regimen and had complete symptom resolution by 4 months, with normalized ultrasound and CA-125. The study is limited to a single patient and does not provide comparative outcomes beyond this case. This paper is centrally about endometriosis-related adenomyosis — specifically cystic adenomyosis of the uterine body treated by laparoscopic surgery.

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Abstract

BACKGROUND: Endometriosis of the uterine body can be manifested as diffuse solid lesions or cystic lesions. The former is common, while the latter is rare, especially for cystic adenomyosis larger than 5 cm. CASE PRESENTATION: A 30-year-old woman was admitted for severe and worsening dysmenorrhea. Ultrasound examination revealed a rare well-circumscribed cystic lesion about 5.5 × 4 × 5.0 cm. CA-125 level was slightly elevated. She accepted laparoscopic surgery and the adenomyotic tissues were excised. The histopathology of the specimen demonstrated the endometrial glands in the walls of cysts and an area of extensive hemorrhage can be seen in the inner wall of cyst. The patient made a good recovery after surgery and her symptoms complete resoluted. CONCLUSIONS: This is a rare case of a cystic adenomyotic lesion that was treated by laparoscopic surgery.

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Condition tags

mesh:D004412mesh:D004715endometriosisadenomyosisdysmenorrhea

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Cysts Cysts Cysts Endometriosis Endometriosis Endometriosis Laparoscopy Adult Dysmenorrhea Dysmenorrhea Female Humans

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