Atypical polypoid adenomyoma

Grindstaff, Samuel; Banet, Natalie

doi:10.1136/ijgc-2020-001886

Cited by 3 publications

(4 citation statements)

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“…It is worth emphasizing that patients with atypical polypoid adenomyoma face a higher overall risk of developing atypical hyperplasia and endometrioid adenocarcinoma of the endometrium compared to those with endometrial polyps. This underscores the importance of careful clinical management in this specific patient population [5].…”

Section: Introductionmentioning

confidence: 85%

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Prolapsed Atypical Polypoid Adenomyoma—A Case Report and Literature Review

Butureanu,

Haliciu,

Apetrei

et al. 2023

Life

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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.

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Section: Introductionmentioning

confidence: 85%

“…Endometrial carcinoma coexists with APAM in 8.8% of cases. APAM has an appearance similar to endometrial carcinoma, adenosarcoma, and carcinosarcoma, so its diagnosis is usually missed [5].…”

Section: Introductionmentioning

confidence: 99%

Prolapsed Atypical Polypoid Adenomyoma—A Case Report and Literature Review

Butureanu,

Haliciu,

Apetrei

et al. 2023

Life

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“…Although uterine polypoid adenomyoma has been referred widely in the literature, typical polypoid adenomyoma in the # Hua He and Nuermanguli Rouzi contributed equally to this work. cervix, containing endometrioid-type glands, has been occasionally mentioned and discussed previously [3][4][5]. In addition, due to its uncommon occurrence, it is often underdiagnosed or misdiagnosed, thus delaying treatment.…”

Section: Introductionmentioning

confidence: 99%

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

He,

Rouzi,

Chen

et al. 2023

J Case Rep Images Oncology

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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.

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“…Atypical polypoid adenomyoma (APA) is an uncommon polypoid lesion located in the lower uterine segment or endometrial cavity, often diagnosed on biopsy or curettage. Reported first by Mazur in 1981, it has the potential of malignant transformation in adenocarcinoma and a high incidence of recurrence, but does not metastasize [ 1 , 2 , 3 , 4 ]. It is a rare tumor, and its diagnosis is usually missed.…”

Section: Introductionmentioning

confidence: 99%

Atypical Polypoid Adenomyoma of the Vagina: Follow Up and Subsequent Evolution: A Case Report and Update

et al. 2022

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Atypical polypoid adenomyoma (APA) is a rare tumor developed from a mix of cells of epithelial and mesenchymal origin. We present the case of an 84-year-old patient with atypical polypoid adenomyoma on the vaginal vault, after total hysterectomy with total adnexectomy for endometrial hyperplasia with atypia four years ago. Not following regular indicated gynecological appointments, the symptoms presented were vaginal bleeding and anemia. The importance of the case consists both in the unique way in which the adenomyoma appears on the vaginal vault and in the subsequent evolution of this pathology. After complete resection, it recurs in five months with a malignant transformation into carcinosarcoma. This fact shows that adenomas can turn not only into carcinomas but also the mesenchymal component can progress to sarcoma, a fact of exceptional rarity. Follow-up and accurate diagnosis are essential for proper management, which is a challenge anyway due to the lack of case studies.

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Atypical polypoid adenomyoma

Cited by 3 publications

References 4 publications

Prolapsed Atypical Polypoid Adenomyoma—A Case Report and Literature Review

Prolapsed Atypical Polypoid Adenomyoma—A Case Report and Literature Review

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

Atypical Polypoid Adenomyoma of the Vagina: Follow Up and Subsequent Evolution: A Case Report and Update

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