Two Cases of Endometrial Adenocarcinoma Arising from Atypical Polypoid Adenomyoma

Cytologic Features of Atypical Polypoid Adenomyoma of the Endometrium

“…6 Although most APAs appear to be benign, coexistent endometrial adenocarcinoma and the subsequent development of endometrial adenocarcinoma have been reported in some cases of APA of the endometrium. 4,7,8,10,11 Therefore, local excision accompanied by close follow-up should be mandatory as a treatment program. As most APAs occur in women of reproductive age, it is very important to obtain a cytologic and histologic diagnosis before surgery to conserve reproductive function.…”

Hysteroscopic treatment of atypical polypoid adenomyoma diagnosed incidentally in a young infertile woman

“…A conservative treatment has been proposed (2,6,14) in women who wish to retain their uterus or in those at high medical risk for hysterectomy. Indeed APAs are often detected in young nulliparous women, sometimes during a workup for infertility.…”

“…Indeed, while in postmenopausal women simple hysterectomy is the treatment of choice (6,7), in young women who wish to preserve their fertility, local resection and a careful postoperative follow-up might represent an appropriate treatment.…”

“…Although most cases are benign (3,5), APA has been occasionally found to coexist with or to precede the development of an endometrioid adenocarcinoma of the endometrium (EEC), which may be either within the APA or elsewhere in the uterus (6)(7)(8)(9). According to the data collected in a recent review of international literature, the average risk of EEC in women with APA is about 8.8%, which is considerably higher than the overall risk of 0.8% reported in women with endometrial polyps (10).…”

Complete hysteroscopic resection of a large atypical polypoid adenomyoma, followed by a successful pregnancy

“…Because APA occurs mainly in women of childbearing age, conservative treatment is required if the patient wishes to preserve her fertility. APA is considered to be a benign form of mixed epithelial and mesenchymal tumor (2); however, it is sometimes found to coexist with or precede an endometrioid adenocarcinoma of the endometrium (3,4). Therefore, extreme care is required when conservative treatment is selected.…”