Laparoscopic excision of uterine adenomatoid tumour: two cases and literature review

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This paper reports two cases of laparoscopic excision of uterine adenomatoid tumours, noting their difficulty in separation from the uterus and friable nature, with simple excision and uterine conservation recommended.

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This paper reports two cases of rare uterine adenomatoid (adenomatoid) tumors treated with laparoscopic excision, with a brief literature review. The authors describe intraoperative challenges including lack of a clear plane between tumor and uterus and difficulty manipulating friable lesions, and they emphasize that simple excision with uterine conservation is commonly chosen because degeneration, recurrence, malignant transformation, or metastasis have not been reported. A specific caveat is that pre-operative diagnosis is difficult because these tumors clinically and radiologically mimic fibroids, which affects operative planning and interpretation of operative planes. Relevance to endometriosis: adenomyosis is explicitly mentioned in the differential diagnosis alongside post-GnRH analogue changes when operative planes are hard to identify, though the study’s main focus is uterine adenomatoid tumors.

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Abstract

IntroductionAdenomatoid tumours are rare, benign neoplasms of the genital tract, occurring most commonly during the reproductive years. In females, the uterus is the most common site. These tumours can be associated with fibroids and tend to mimic them clinically and radiologically, making pre-operative diagnosis very difficult. We report two cases of uterine adenomatoid tumours that were excised laparoscopically. Intraoperatively, there was no clear line of demarcation between the uterus and the tumours and laparoscopic manipulation of the tumours was difficult due to their friable nature. Simple excision with uterine conservation is the treatment of choice, especially in women who desire future fertility, as degeneration, recurrence, malignant transformation or metastasis has not been reported.ConclusionAdenomatoid tumours should always be included in the differential diagnosis along with adenomyosis and post-GnRH analogue treatment changes, when difficulty is encountered in identification of operative planes during a routine laparoscopic myomectomy. Apart from explaining the operative difficulties, the identification of these tumours also helps in post-operative counselling of these patients as these tumours unlike fibroids do not recur.
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Abstract

Introduction Adenomatoid tumours are rare, benign neoplasms of the genital tract, occurring most commonly during the reproductive years. In females, the uterus is the most common site. These tumours can be associated with fibroids and tend to mimic them clinically and radiologically, making pre-operative diagnosis very difficult. We report two cases of uterine adenomatoid tumours that were excised laparoscopically. Intraoperatively, there was no clear line of demarcation between the uterus and the tumours and laparoscopic manipulation of the tumours was difficult due to their friable nature. Simple excision with uterine conservation is the treatment of choice, especially in women who desire future fertility, as degeneration, recurrence, malignant transformation or metastasis has not been reported.

Conclusion

Adenomatoid tumours should always be included in the differential diagnosis along with adenomyosis and post-GnRH analogue treatment changes, when difficulty is encountered in identification of operative planes during a routine laparoscopic myomectomy. Apart from explaining the operative difficulties, the identification of these tumours also helps in post-operative counselling of these patients as these tumours unlike fibroids do not recur. Similar content being viewed by others

References

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MeSH descriptors

Adenomatoid Tumor Uterine Neoplasms Adenomatoid Tumor Adenomatoid Tumor Adult Female Histocytochemistry Humans Laparoscopy Uterine Neoplasms Uterine Neoplasms

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