Hysteroscopic transcervical resection is useful to diagnose myometrial invasion in atypical polypoid adenomyoma coexisting with atypical endometrial hyperplasia or endometrial cancer with suspicious myometrial invasion

Abstract

In patients with APAM and AEH or EMG1, TCR may aid accurate diagnosis when myometrial invasion is unclear on diagnostic imaging.

Recurrent atypical polypoid adenomyoma and pregnancy: A new conservative approach with levonorgestrel-releasing intrauterine system

“…In post-menopause hysterectomy is the treatment of choice, while in patients who may want to preserve the fertility potential a conservative surgical procedure has been suggested (Matsumoto et al, 2013, Yamagami et al, 2015, Nomura et al, 2015, Di Spiezio Sardo et al, 2008). …”

Successful laparotomy tumor resection and levonorgestrel‐releasing intrauterine system for atypical polypoid adenomyoma

“…The recurrence rate after TCR is lower than that after D&C . This is because TCR can more accurately locate the lesion than D&C, and reduce the possibility of lesion remnants . However, a recurrence rate of 10–33%, even after MPA therapy and megestrol acetate therapy, has been reported .…”

“…To the best of our knowledge, this is the first report in English of laparotomy tumor resection for APA. There are a few recent reports on fertility sparing treatments using medroxyprogesterone acetate (MPA) in patients with APA . Terada reported in an immunohistochemical study that the glands and mesenchymal elements involved in APA were consistently positive for the estrogen receptor and progesterone receptor .…”

“…This is because TCR can more accurately locate the lesion than D&C, and reduce the possibility of lesion remnants . However, a recurrence rate of 10–33%, even after MPA therapy and megestrol acetate therapy, has been reported . To improve the results, more accurate evaluation of the lesion is necessary.…”

“…However, as the common age of APA onset is approximately 40 years, fertility sparing treatment is often required. Hysteroscopic transcervical resection (TCR) or dilatation and curettage (D&C) is often performed as fertility sparing treatment . Although TCR was reported to yield a lower recurrence rate than D&C, TCR has the risk of uterine wall perforation .…”