Prolapsed Atypical Polypoid Adenomyoma—A Case Report and Literature Review
Author:
Butureanu Tudor12ORCID, Haliciu Ana-Maria12, Apetrei Ana-Maria12, Pavaleanu Ioana12ORCID, Socolov Razvan Vladimir12, Balan Raluca Anca23ORCID
Affiliation:
1. Department of Mother and Child, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania 2. “Elena Doamna” University Hospital of Obstetrics and Gynecology, 49, Elena Doamna St., 700398 Iasi, Romania 3. Department of Morpho-Functional Sciences I, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Abstract
Atypical polypoid adenomyoma (APAM) is a rare polypoid benign tumor of the uterus that causes irregular vaginal bleeding in women of reproductive age. It has the potential for malignant transformation, but it does not metastasize. APAM may coexist with endometrial hyperplasia and adenocarcinoma, usually leading to misdiagnosis. Histopathologically, it is a biphasic tumor, represented by the endometrioid glands with a complex histoarchitecture, with sometimes squamous morular metaplasia or cytologic atypia, interspersed with a fibromyomatous stroma. This tumor has a high incidence of recurrence. We present a very rare case of a 21-year-old patient, a virgin, without a significant medical history, with a bleeding mass occupying the vagina. The mass was excised using forceps, scissors, and a suture of the visible pedicle. After a four-year follow-up and no additional medical treatment, no relapse was observed. Given the risk of recurrence and progression, APAM might be treated via a hysterectomy in patients with no desire for pregnancy. Due to a lower recurrence rate, the conservative treatment of atypical polypoid adenomyoma performed via an operative hysteroscopy represents the best choice. Previously diagnosed in hysterectomy specimens, with the introduction of better-performing indirect imaging techniques, adenomyosis is a clinical entity that has the possibility of being diagnosed in the presurgical stage.
Subject
Paleontology,Space and Planetary Science,General Biochemistry, Genetics and Molecular Biology,Ecology, Evolution, Behavior and Systematics
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