Laparoscopic management of juvenile cystic adenomyoma of the uterus: Report of two cases and review of the literature

Takeda, Akihiro; Sakai, Kotaro; Mitsui, Takashi; Nakamura, Hiromi

doi:10.1016/j.jmig.2007.01.005

Cited by 55 publications

(99 citation statements)

References 13 publications

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“…At histologic analysis, adenomyotic cysts are cavities lined by endometrial epithelium [18]. The stroma below the epithelium is thin throughout the cyst and contains red blood cells and hemosiderin-laden macrophages.…”

Section: Discussionmentioning

confidence: 99%

Adenomyotic Cyst in a 25-Year-Old Woman: Case Report

Cucinella

Billone

Pitruzzella

et al. 2013

Journal of Minimally Invasive Gynecology

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Adenomyotic cysts are uncommon findings, usually in the context of diffuse adenomyosis and ,5 mm in diameter. Herein we report a 4.5-cm adenomyotic cyst in a 25-year-old nulliparous woman with severe dysmenorrhea and pelvic pain. Transvaginal ultrasonography and magnetic resonance imaging revealed a well-circumscribed hypoechogenic mass in the posterior uterine wall, well separated from the uterine cavity. Pathologic analysis demonstrated that the cyst was lined with endometrial epithelium and stroma and was surrounded by smooth muscle hyperplasia. In the literature, we found 30 reports of cysts with similar characteristics. Because this cyst has not been clearly defined, it has been called by various names including adenomyotic cyst, cystic adenomyosis, and cystic adenomyoma. We believe this lesion should not be called an adenomyoma, but is more correctly called an adenomyotic cyst or, depending on age at onset, a juvenile adenomyotic cyst.

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Section: Discussionmentioning

confidence: 99%

Adenomyotic Cyst in a 25-Year-Old Woman: Case Report

Cucinella

Billone

Pitruzzella

et al. 2013

Journal of Minimally Invasive Gynecology

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“…Cystic adenomyosis can be divided into an adult form, which is present in 5-7% of hysterectomy fibroid uteri [1] and often associated with the diffuse subtype, and a juvenile form seen in nulliparous women between 13 and 20 years of age, for which the true incidence is not known; less than ten cases have been reported to date [2][3][4][5][6][7][8][9], most of them in Japan. Although the aetiology is still a cause for debate, the adult form appears to result from traumatic breech of the interface between the endometrium and the myometrium, for instance after uterine instrumentation followed by bleeding into dispersed endometrial glands, which become dilated and turn into cystic spaces of typically less than 5 mm in diameter.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic resection of cystic adenomyosis in a teenager with arcurate uterus

et al. 2009

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Whereas diffuse adenomyosis is a common finding in parous women, cystic adenomyosis causing severe dysmenorrhoea is very rarely reported and possibly under-diagnosed, particularly in adolescents. We report a case of juvenile cystic adenomyosis in a 19-year-old nulliparous patient presenting with secondary dysmenorrhoea and non-cyclical pain. A 20-mm adenomyotic cyst in the fundal myometrium was successfully excised laparoscopically by modified myomectomy. It is mandatory to take persistent primary and early secondary dysmenorrhoea seriously, especially after poor response to medical treatment and to have a low threshold for further investigations, because a diagnosis of cystic adenomyosis requires targeted therapeutic intervention.

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“…in most cases (95.4%), authors noted the administration of one or more pre-operative medical therapies, that were ineffective both on the lesion and on symptomatology. there was some variability in the terms used to define the reported pathology: cystic adenomyoma (1, 9-11), cystic adenomyosis (5) and juvenile cystic adenomyosis (JCA, in the cases of young patients) (3,7,(12)(13)(14). only for 12 cases was the pre-operative CA125 value reported, and in 6 cases this was elevated (up to 551 u/ml).…”

Section: Resultsmentioning

confidence: 99%

“…the first described surgical step was the introduction of a 10 mm laparoscope through an umbilical port, and then further ports (from 5mm to 12mm in diameter) were variably placed under-vision on the lower abdomen; variations included: the use of an accessory 12 mm port inserted into the left upper abdomen on the anterior axillary line on the surgeon's side (7) and 12 mm suprapubic port (3). recognition of location of the lesion was usually easy due to large dimension of the cystic mass.…”

Section: Resultsmentioning

confidence: 99%

“…it is typically diagnosed in parous women and is thought to affect 1% of women, typically diagnosed in the 4 th and 5 th decades of life (1,2). the diffuse form, characterized by the presence of blood-filled cystic spaces, < 5 mm in greatest diameter (3,4), is typically diagnosed in multiparous premenopausal women and is present in up to 20% of hysterectomy specimens (5). Focal adenomyosis rarely occurs.…”

Section: Introductionmentioning

confidence: 99%

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