Cystic adenomyosis spreading into subserosal-peduncolated myoma: How to explain it? - PubMed
Cystic adenomyosis spreading into subserosal-peduncolated myoma: How to explain it?
Gloria Calagna et al. Int J Surg Case Rep. 2015.
Abstract
Introduction: Cystic adenomyosis is a rare variant of adenomyosis characterized by well- circumscribed cavitated endometrial gland and stroma located within the myometrium. The cysts usually measure≥1cm in diameter, contain a "chocolate-colored" fluid and do not open into the overlaying endometrium.
Case presentation: We present a case of a peduncolated-subserosal cystic adenomyoma, namely cystic adenomyosis, correlated with pelvic MR imaging, laparoscopic surgery technique and histopathology findings.
Conclusions: In this case, the peculiar growth pattern of cystic adenomyosis in a myoma represents a singular condition rarely reported in the medical literature. We therefore support the pathogenetic theory that the disease might have been caused by direct proliferation of endometrial cells within a peduncolated- subserosal myoma.
Keywords: Adenomyosis; Cystic adenomyosis; Laparoscopy; Myoma.
Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Figures
T2-weighted contrast- enhancement MR imaging showing the two hypointense signal inside the antero-lateral and right-sided myoma (white arrows).
Laparoscopic finding of the uterus (U) with the antero-lateral and the posterior myoma .
Laparoscopic finding at the time of morcellament of the “core” of the antero-lateral myoma. The spillage of “chocolate colored” fluid is clearly seen.
Pathology. Diagnostic patterns of adenomyosis are demonstrated: endometrial glands and stroma intermixed with smooth muscular fibers (left-hand and upper side). Smooth muscle fibers (SMF) are more prominent with no glandular structures (left and bottom side). The glands are enlarged with cellular debris in the lumen (blue star, right-hand side). This histologic findings are consistent with a diagnosis of cystic adenomyosis.
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