A case report of a rare endocervical-type typical polypoid adenomyoma

Abstract

Introduction: Endocervical-type typical polypoid adenomyoma is an exceptionally rare benign tumor, which should be seldom reported to date. We aim to share our clinical experience about endocervical-type typical polypoid adenomyoma and review relevant publications to decrease the rates of misdiagnosis and missed diagnosis. Case Report: A 15-year-old adolescent had recurrent irregular vaginal bleeding persisting for six months, and the vaginal mass could not be returned after toileting finally. Ultrasound examination revealed a huge mass with heterogeneous hypoechogenicity and prominent intramural blood flow, comprising multiple cystic areas. Magnetic resonance imaging demonstrated significant endometrial thickening, and a well-defined pedunculated mass of varying signal intensity protruding into the vaginal orifice. Hysteroscopy was performed, and a pathologic biopsy of the mass was conducted. Pathological analysis revealed an endometrial epithelial monolayer overlaying the tissue, with subtle glandular hyperplasia and partial gland expansion. The stroma consisted of fibrous connective tissue with a few smooth muscle fibers. Conclusion: The prolapsed mass was confirmed as an endocervical-type typical polypoid adenomyoma. We successfully eradicated the tumor through hysteroscopy, leading to the restoration of normal cervical morphology, correction of anemia, and normalization of body temperature. During the procedure, we directly observed the pink mass, exhibiting cystic changes, encircling the hypertrophied cervix. Persistent exposure to high-dose estrogen may potentially play a significant role in the development of polypoid adenomyoma.