A case of rapidly-growing atypical polypoid adenomyoma which was histologically diagnosed before operation and removed by a laparoscopic resection

Nakabayashi, Akira; Takahashi, Nobuko; Hashimoto, Kazunori; Nagata, Reiko; Hashimoto, Tomomi; Yamamoto, Tomoko

doi:10.1016/j.tjog.2017.12.019

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…We reviewed 27 cases of APAs with cytological findings reported in the English literature (Table 2). 8‐11,13‐26 Seven of those cases involved neither atypical glandular cells nor spindle cells of APAs, similar to Cases 1 and 2. This suggests that cytological sampling of APAs is more difficult than expected.…”

Section: Discussionmentioning

confidence: 60%

“…In contrast, routine cytology of specimens in Cases 1-5 did not reveal spindle cells (Table 1) We reviewed 27 cases of APAs with cytological findings reported in the English literature (Table 2). [8][9][10][11][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Our data suggest that the LTC method is an appropriate approach to increase the diagnostic accuracy of APAs.…”

Section: Cytological Findingsmentioning

confidence: 99%

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Lesion‐targeted cytology to improve cytological sampling for atypical polypoid adenomyomas of the uterus: A case series and review of the literature

et al. 2020

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Atypical polypoid adenomyomas (APAs) are uncommon mixed epithelial and mesenchymal tumours of the uterus. Patients present with abnormal uterine bleeding or hypermenorrhoea. Histologically, they are composed of atypical endometrioid glands that show architectural complexity or various cellular atypia embedded in a myomatous or fibromyomatous stroma that often contains squamous morules. 1-4 These findings might be confused as those corresponding to adenocarcinoma-infiltrating myometrium. However, APAs are more likely to be associated with atypical endometrial hyperplasia and/or endometrioid adenocarcinoma.

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Section: Discussionmentioning

confidence: 60%

Section: Cytological Findingsmentioning

confidence: 99%

Lesion‐targeted cytology to improve cytological sampling for atypical polypoid adenomyomas of the uterus: A case series and review of the literature

et al. 2020

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Atypical polypoid adenomyoma follow-up and management

et al. 2020

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Background: Atypical polypoid adenomyoma (APA) is a rare uterine tumor typically found in fertile age and associated with infertility. Among young nullipara women, conservative treatment is proposed despite the high recurrence rate and the association with endometrial cancer. Our aim was to assess the risk of recurrence with different conservative treatments in fertile ages and the prevalence of malignant or pre-malignant associated lesions to better address an adequate patient counselling when treatment modalities are discussed. Methods: This study is a systematic review and meta-analysis of case reports and case series about APA management and follow-up. A literature search was carried from Medline and Scopus for studies published from January 1, 1980 to December 31, 2018. Results: We included 46 observational studies and 296 cases in fertile women. The prevalence of APA relapse was 44% (CI.95 33–57%) and was lower in cases treated with operative hysteroscopy (22%; CI.95 11–39%) than in cases treated with blind curettage and polypectomy (38%; CI.95 15–67%). The prevalence of the concomitant or during the follow-up diagnosis of endometrial carcinoma was 16% (CI.95 9–29%). The risk of cancer development during follow-up was significantly less in cases treated with histeroscopy (10.56% new cumulative diagnosis at 5 years follow up; CI.95 0–23.7%) than blind curettage and polypectomy (35.5% new cumulative diagnosis at 5 years; CI.95 11.65–52.92%; P < .05). Medical treatment with medroxyprogesterone acetate after surgery does not reduce APA recurrence. Pregnancy was observed in 79% cases in which the desire was expressed. Conclusion: This review suggests that conservative treatment performed by operative hysteroscopy is the optimal choice because it lowers the risk of recurrence, improves the accuracy of concomitant carcinoma or hyperplasia diagnosis, and leaves the possibility of future pregnancies.

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A case of rapidly-growing atypical polypoid adenomyoma which was histologically diagnosed before operation and removed by a laparoscopic resection

Abstract: This is the first report of APAM treated by laparoscopic resection. The method may be a useful alternative when hysteroscopic surgery is inappropriate.

Cited by 2 publications

References 6 publications

Lesion‐targeted cytology to improve cytological sampling for atypical polypoid adenomyomas of the uterus: A case series and review of the literature

Lesion‐targeted cytology to improve cytological sampling for atypical polypoid adenomyomas of the uterus: A case series and review of the literature

Atypical polypoid adenomyoma follow-up and management

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