MRI and Transvaginal Ultrasound Findings of Atypical Polypoid Adenomyoma: A Case Report

Tan Ya; Hu Xue; Song Xin; Zhang Wenjun

doi:10.24920/003911

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MRI and Transvaginal Ultrasound Findings of Atypical Polypoid Adenomyoma: A Case Report

Chinese Medical Sciences Journal Vol. 37, Issue 1, Pages: 82-86(2022)

Case Report | Updated：2024-04-10

- MRI and Transvaginal Ultrasound Findings of Atypical Polypoid Adenomyoma: A Case Report
- Affiliations：
  
  1. 1Department of Ultrasonography, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
  2. 2Obstetrics and Gynecology Medical Center, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
- Author bio：
  
  *E-mail: pulushi38@126.com.
- Funds：
- DOI：10.24920/003911
  CLC：
- Received：06 April 2021，
  
  Accepted：2021-7-9，
  
  Published Online：04 March 2022，
  
  Published：31 March 2022
- Accepted：
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Tan Ya, Hu Xue, Song Xin, et al. MRI and Transvaginal Ultrasound Findings of Atypical Polypoid Adenomyoma: A Case Report[J]. Chinese medical sciences journal, 2022, 37(1): 82-86.
DOI：

Tan Ya, Hu Xue, Song Xin, et al. MRI and Transvaginal Ultrasound Findings of Atypical Polypoid Adenomyoma: A Case Report[J]. Chinese medical sciences journal, 2022, 37(1): 82-86. DOI： 10.24920/003911.

摘要

非典型息肉样腺肌瘤（atypical polypoid adenomyoma

APA）是一种罕见类型的息肉

其病理特征主要是肌瘤间质和子宫内膜腺体相间。APA主要发生在绝经前女性

很少发生在伴有不规则阴道出血的绝经后女性。本例76岁绝经女性表现为不规则阴道出血

最终病理诊断为APA。APA在手术前不易诊断：一方面

APA的影像学和临床特征无明显的特殊性

尤其是在与子宫内膜癌的鉴别方面;另一方面

APA有一个蒂

可以附着在宫腔的任何部分

这可能导致肿块与宫腔壁之间形成假腔

因此

在没有宫腔镜检查的情况下获取病理组织时

很容易通过假腔获得子宫内膜组织

而不是肿块的病理组织。因此

术前影像学检查对临床医师诊断APA具有重要意义;同时

可在宫腔镜直视条件下获得APA的病理组织。

Abstract

Atypical polypoid adenomyoma (APA) is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands. It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal bleeding. In our current case

a 76-year-old woman presented with irregular vaginal bleeding. The final pathological diagnosis of the mass was APA. APA is not easy to diagnose before surgery. On the one hand

there was no obvious particularity in imaging features and clinical features

especially for uncomfortably identifying endometrial cancer. On the other hand

APA has a pedicle

attaching to any part of the uterine cavity

which can cause pseudocoel between the mass with the uterine cavity wall. So

when it comes to getting the pathological tissue in the absence of hysteroscopy

it is easy to access to the pseudocoel and obtain endometrial tissue rather than the pathological tissue of the mass. Therefore

preoperative imaging examination is of great significance diagnosis way of thinking to clinicians for APA. In the meantime

pathological tissue of APA can be obtained by hysteroscopy in visual conditions.

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references

McCluggage WG , Alderdice JM , Walsh MY . Polypoid uterine lesions mimicking endometrial stromal sarcoma . J Clin Pathol 1999 ; 52 ( 7 ): 543 - 6 .

Kenny SL , McCluggage WG . Adenomyomatous polyp of the endometrium with prominent epithelioid smooth muscle differentiation: report of two cases of a hitherto undescribed lesion . Int J Surg Pathol 2014 ; 22 ( 4 ): 358 - 63 . doi: 10.1177/1066896913499630 https://dx.doi.org/10.1177/1066896913499630 . DOI: 10.1177/1066896913499630 http://doi.org/10.1177/1066896913499630 http://journals.sagepub.com/doi/10.1177/1066896913499630 http://journals.sagepub.com/doi/10.1177/1066896913499630

Lin YH ., Chou YY , Huang LW , et al . An adenomyomatous polyp presenting as a large hypervascular tumor and its response to a gonadotropin-releasing hormone agonist . Taiwan J Obstet Gynecol 2013 ; 52 ( 1 ): 129 - 30 . doi: 10.1016/j.tjog.2013.01.016 https://dx.doi.org/10.1016/j.tjog.2013.01.016 DOI: 10.1016/j.tjog.2013.01.016 http://doi.org/10.1016/j.tjog.2013.01.016 https://linkinghub.elsevier.com/retrieve/pii/S1028455913000260 https://linkinghub.elsevier.com/retrieve/pii/S1028455913000260

Carugno J . Clinical management of vaginal bleeding in postmenopausal women . Climacteric 2020 ; 23 ( 4 ): 343 - 49 . doi: 10.1080/13697137.2020.1739642 https://dx.doi.org/10.1080/13697137.2020.1739642 . DOI: 10.1080/13697137.2020.1739642 http://doi.org/10.1080/13697137.2020.1739642

Gilks CB , Clement PB , Hart WR , et al . Uterine adenomyomas excluding atypical polypoid adenomyomas and adenomyomas of endocervical type: a clinicopathologic study of 30 cases of an underemphasized lesion that may cause diagnostic problems with brief consideration of adenomyomas of other female genital tract sites . Int J Gynecol Pathol 2000 ; 19 ( 3 ): 195 - 205 . doi: 10.1097/00004347-200007000-00001 https://dx.doi.org/10.1097/00004347-200007000-00001 . DOI: 10.1097/00004347-200007000-00001 http://doi.org/10.1097/00004347-200007000-00001

Nakai G , Kitano R , Yamamoto K , et al . Magnetic resonance imaging findings in atypical polypoid adenomyoma . J Comput Assist Tomogr 2015 ; 39 ( 1 ): 32 - 6 . doi: 10.1097/RCT.0000000000000169 https://dx.doi.org/10.1097/RCT.0000000000000169 . DOI: 10.1097/RCT.0000000000000169 http://doi.org/10.1097/RCT.0000000000000169

Lee EJ , Joo HJ , Ryu HS . Sonographic findings of uterine polypoid adenomyomas . Ultrasound Q 2004 ; 20 ( 1 ): 2 - 11 . doi: 10.1097/00013644-200403000-00002 https://dx.doi.org/10.1097/00013644-200403000-00002 . DOI: 10.1097/00013644-200403000-00002 http://doi.org/10.1097/00013644-200403000-00002 http://journals.lww.com/00013644-200403000-00002 http://journals.lww.com/00013644-200403000-00002

Lee, EJ , J.H. Han , HS Ryu , Polypoid adenomyomas: sonohysterographic and color Doppler findings with histopathologic correlation . J Ultrasound Med 2004 ; 23 ( 11 ): 1421 - 9 . doi: 10.7863/jum.2004.23.11.1421 https://dx.doi.org/10.7863/jum.2004.23.11.1421 . DOI: 10.7863/jum.2004.23.11.1421 http://doi.org/10.7863/jum.2004.23.11.1421

Kalmantis K , Daskalakis G , Semertzidou A , et al . The role of three-dimensional power Doppler hysterosonography (3-DPDS) in distinguishing atypical polypoid adenomyomas (APAs) from other intrauterine tumors: correlation with pathologic findings . Arch Gynecol Obstet 2017 ; 296 ( 2 ): 391 - 396 . doi: 10.1007/s00404-017-4436-3 https://dx.doi.org/10.1007/s00404-017-4436-3 . DOI: 10.1007/s00404-017-4436-3 http://doi.org/10.1007/s00404-017-4436-3 http://link.springer.com/10.1007/s00404-017-4436-3 http://link.springer.com/10.1007/s00404-017-4436-3

Takeuchi M , Matsuzaki K . Adenomyosis: usual and unusual imaging manifestations, pitfalls, and problem-solving MR imaging techniques . Radiographics 2011 ; 31 ( 1 ): 99 - 115 . doi: 10.1148/rg.311105110 https://dx.doi.org/10.1148/rg.311105110 . DOI: 10.1148/rg.311105110 http://doi.org/10.1148/rg.311105110

Faria SC , Devine CE , Rao B , et al . Imaging and staging of endometrial cancer . Semin Ultrasound CT MR 2019 ; 40 ( 4 ): 287 - 94 . doi: 10.1053/j.sult.2019.04.001 https://dx.doi.org/10.1053/j.sult.2019.04.001 . DOI: S0887-2171(19)30022-8 http://doi.org/S0887-2171(19)30022-8

Visser NCM , Breijer MC , Herman MC , et al . Factors attributing to the failure of endometrial sampling in women with postmenopausal bleeding . Acta Obstet Gynecol Scand 2013 ; 92 ( 10 ): 1216 - 22 . doi: 10.1111/aogs.12212 https://dx.doi.org/10.1111/aogs.12212 . DOI: 10.1111/aogs.12212 http://doi.org/10.1111/aogs.12212

Raffone A , Travaglino A , Saccone G , et al . Management of women with atypical polypoid adenomyoma of the uterus: A quantitative systematic review . Acta Obstet Gynecol Scand 2019 ; 98 ( 7 ): 842 - 55 . doi: 10.1111/aogs.13553 https://dx.doi.org/10.1111/aogs.13553 . DOI: 10.1111/aogs.13553 http://doi.org/10.1111/aogs.13553 https://onlinelibrary.wiley.com/toc/16000412/98/7 https://onlinelibrary.wiley.com/toc/16000412/98/7

Bai TJ , Bao DM , Li Y , et al . Atypical polypoid adenomyoma of the uterus: a clinicopathological review of 27 cases . Zhonghua Fu Chan Ke Za Zhi 2017 ; 52 ( 4 ): 244-8. Chinese. doi: 10.3760/cma.j.issn.0529-567X.2017.04.006 https://dx.doi.org/10.3760/cma.j.issn.0529-567X.2017.04.006 . DOI: 10.3760/cma.j.issn.0529-567X.2017.04.006 http://doi.org/10.3760/cma.j.issn.0529-567X.2017.04.006

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