Polypoid cystic adenomyosis of the uterus: report of a case

Dobashi Y, Y Dobashi, Fiedler PN, P N Fiedler, Carcangiu ML, M L Carcangiu
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 1992 · vol. 11(3) , pp. 240–3 · doi:10.1097/00004347-199207000-00012 · PMID:1399231
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This case report describes a 43-year-old woman with abnormal vaginal bleeding and polypoid cystic adenomyosis, characterized by a firm mass with a central cystic cavity communicating with the endometrial cavity.

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This case report describes a 43-year-old woman presenting with eight years of abnormal vaginal bleeding and a polypoid uterine mass. Hysteroscopic evaluation initially suggested a submucosal leiomyoma, but subsequent hysterectomy revealed a unique form of focal adenomyosis featuring a large cystic cavity filled with bloody fluid. The lesion was lined by endometrial mucosa and contained endometrial islands within the intervening wall, communicating with the endometrial cavity via a fistula-like tract. The authors note that this presentation mimics other conditions such as polypoid submucosal leiomyoma or endometrial polyps, highlighting the diagnostic challenge of this rare variant. This paper is centrally about adenomyosis — specifically a rare polypoid cystic variant of focal adenomyosis of the uterus.

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Abstract

A case of focal adenomyosis of the uterus with unusual gross features is presented. The patient, a 43-year-old woman, had experienced abnormal vaginal bleeding for 8 years. Hysteroscopy revealed a polypoid mass compatible with a submucosal leiomyoma, and a hysterectomy was performed. The uterus showed a 7 x 5 x 3-cm firm polypoid mass attached to the anterior wall that occupied most of the uterine cavity and protruded through the cervical os. It contained a large, central, cystic cavity filled with bloody fluid that communicated with the endometrial cavity through a fistula-like tract. Both the surface of the mass and the inside of the cystic cavity were covered by endometrial mucosa, and there were endometrial islands in the intervening wall. The differential diagnosis of this unique form of adenomyosis included polypoid submucosal leiomyoma with invagination of endometrium, endometrial polyp, submucosal leiomyoma with invagination of endometrium, endometrial polyp, and uterine diverticulum.
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Polypoid Cystic Adenomyosis of the Uterus Report of a Case - Yoh Dobashi - Paul N. Fiedler - Maria L. Carcangiu Summary A case of focal adenomyosis of the uterus with unusual gross features is presented. The patient, a 43-year-old woman, had experienced abnormal vaginal bleeding for 8 years. Hysteroscopy revealed a polypoid mass compatible with a submucosal leiomyoma, and a hysterectomy was performed. The uterus showed a 7 × 5 × 3-cm firm polypoid mass attached to the anterior wall that occupied most of the uterine cavity and protruded through the cervical os. It contained a large, central, cystic cavity filled with bloody fluid that communicated with the endometrial cavity through a fistula-like tract. Both the surface of the mass and the inside of the cystic cavity were covered by endometrial mucosa, and there were endometrial islands in the intervening wall. The differential diagnosis of this unique form of adenomyosis included polypoid submucosal leiomyoma with invagination of endometrium, endometrial polyp, and uterine diverticulum.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Endometriosis Uterine Neoplasms Adult Adult Endometriosis Endometriosis Female Female Humans Humans Uterine Neoplasms Uterine Neoplasms

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europepmc
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pubmed
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