Atypical Polypoid Adenomyoma (APAM)

Javed, Lubna; Ashraf, Nadia; Sabqat, Mashaal; Zareen, Amtullah

doi:10.29271/jcpsp.2021.06.719

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…Based on publication data, atypical polypoid adenomyoma (APA) is an endometrial tumor with low malignant potential and low incidence rate, which generally occurs in patients of reproductive age. Being considered as an indicator or precursor for endometrial endometrioid adenocarcinoma or coexisted with endometrioid adenocarcinoma [ 6 , 7 , 8 ], it should be treated from the beginning as a potential-aggressive tumor in order to avoid delays in therapy. Moreover, it is mandatory to inform the patient about all these risks.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Protrusions are often present as polyps and submucosal myomas; however, they might also be present in atypical and malignant diseases such as atypical polypoid adenomyoma and some EC. 6,7 Desquamation is when a small white mass, assumed to be necrotic tissue flaking from the endometrium, floats in the uterine cavity and appears as a snowstorm. This phenomenon has been previously reported to be a characteristic observed, for example, in patients with abnormal uterine bleeding and irregular endometrium or malignant possibility.…”

Section: Hysteroscopymentioning

confidence: 99%

“…Atypical vessels include those with meandering, expansion, inconsistent diameter, and disruption, frequently mentioned as features representing endometrial malignancy. 4,6,10 A white/ yellow lesion indicates focal necrosis or microcalcifications on the endometrial surface. 5 An experienced consultant, blinded to the pathology results, retrospectively judged these five features as positive or negative using hysteroscopy videos.…”

Section: Hysteroscopymentioning

confidence: 99%

Characteristic hysteroscopy appearance considerations for detecting uterine endometrial malignancies

Matsumoto,

Yamaguchi,

Maruyama

et al. 2024

J of Obstet and Gynaecol

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AimThe effectiveness of hysteroscopy in diagnosing endometrial lesions has been demonstrated, showing high diagnostic accuracy for malignant endometrial lesions. Although the characteristic appearances of atypical and malignant endometria have been reported, they are not definitive and sometimes complicated. This study aimed to identify a small number of characteristic features to detect endometrial abnormalities using a simple judgment system and analyze the diagnostic characteristics and their accuracy in endometrial malignancy diagnosis.MethodsWe performed a retrospective analysis of hysteroscopy video data of 250 patients, of which we selected for analysis based on pathology examination 152 cases with benign changes, 16 with atypical endometrium, and 18 with carcinoma in situ or endometrial cancer. Endometrial characteristics assessed included protrusion, desquamation, extended vessel, atypical vessel, and white/yellow lesion.ResultsMultivariable analysis revealed that desquamation (p = 0.001, odds ratio [OR] 5.28), atypical vessels (p < 0.001, OR 8.50), and white/yellow lesions (p = 0.011, OR 1.37) were significant predictors for endometrial malignancy. From their contribution status, scoring points of 4, 6, and 1 were settled according to the odds ratio proportions. When scores ≥5 (at least both desquamation and white/yellow lesions or only atypical vessels) were used to define endometrial malignancy, sensitivity and specificity were 100% and 92%, respectively. When detecting cancer, atypical, and benign cases, sensitivity and specificity were 88% and 90%, respectively.ConclusionOur characteristics hysteroscopic findings showed a higher predictive ability in detecting endometrial malignancies. However, further examination with more cases would be needed to accurately diagnose endometrial malignancy by hysteroscopy.

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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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Atypical Polypoid Adenomyoma (APAM)

Cited by 3 publications

References 2 publications

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

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

Characteristic hysteroscopy appearance considerations for detecting uterine endometrial malignancies

Prolapsed Atypical Polypoid Adenomyoma—A Case Report and Literature Review

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