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[Atypical polypoid adenomyoma of the uterus: a clinicopathological review of 27 cases].
Zhonghua Fu Chan Ke Za Zhi. 2017 Apr 25; 52(4):244-248.ZF

Abstract

Objective:

To investigate the clinical and pathological characteristics of atypical polypoid adenomyoma (APA) for improvement of the diagnosis, different diagnosis and treatment of the disease.

Methods:

The clinical data, pathological characteristics, and the follow-up information were retrospectively analyzed in 27 cases of APA admitted in Peking Univeristy People's Hospital from 2007 to 2016.

Results:

The median age was 42.6 years old (range 25-60 years old). Fifteen patients were nullipara, 2 patients were postmenopausal. The most common presenting symptom was abnormal uterine bleeding (81%, 22/27) . Leisions were obtained by using hysteroscopy in 23 cases, hysterectomy 3 cases and dilatation and curettage 1 case. Fertility preserving treatments were performed in 10 patients who had strong desire for fertility, among which 1 case progressed into endometrial carcinoma. Among 15 patients underwent hysterectomy and (or) bilateral salpingo-oophorectomy, 9 cases of them had endometrial atypical hyperplasia. Endometrial carcinoma along with APA were found in three patients, 2 cases of them underwent hysterectomy and bilateral salpingo-oophorectomy and pelvic lymphadenectomy, the other one received medication for fertility preservation. Follow up information were available in 24 cases (89%, 24/27) with a median follow up of 46 months (range 4-108 months), 1 case recurred and 1 case progressed into endometrial carcinoma. One case died of other malignancy, while the other patients were alive.

Conclusions:

APA is a rare uterine neoplasm mixed with epithelial and mesenchymal component. It occurs mostly in childbearing-age women and its diagnosis is dependent on pathology. Although it's clinical course is benign, there is risk of co-existance of endometrial carcinoma and endometrial atypical hyperplasia. For those who has desire of fertility, the treatment strategy is completely removed the lesion and closely followed up. For those who do not desire to preserve fertility, hysterectomy may be an option.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Peking Univeristy People's Hospital, Beijing 100044, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

chi

PubMed ID

28441840

Citation

Bai, T J., et al. "[Atypical Polypoid Adenomyoma of the Uterus: a Clinicopathological Review of 27 Cases]." Zhonghua Fu Chan Ke Za Zhi, vol. 52, no. 4, 2017, pp. 244-248.
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):244-248.
Bai, T. J., Bao, D. M., Li, Y., Wang, Y., Cui, H., & Zhu, H. L. (2017). [Atypical polypoid adenomyoma of the uterus: a clinicopathological review of 27 cases]. Zhonghua Fu Chan Ke Za Zhi, 52(4), 244-248. https://doi.org/10.3760/cma.j.issn.0529-567X.2017.04.006
Bai TJ, et al. [Atypical Polypoid Adenomyoma of the Uterus: a Clinicopathological Review of 27 Cases]. Zhonghua Fu Chan Ke Za Zhi. 2017 Apr 25;52(4):244-248. PubMed PMID: 28441840.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Atypical polypoid adenomyoma of the uterus: a clinicopathological review of 27 cases]. AU - Bai,T J, AU - Bao,D M, AU - Li,Y, AU - Wang,Y, AU - Cui,H, AU - Zhu,H L, PY - 2017/4/27/entrez PY - 2017/4/27/pubmed PY - 2017/7/25/medline KW - Adenomyoma KW - Endometrial neoplasms KW - Pathology, clinical SP - 244 EP - 248 JF - Zhonghua fu chan ke za zhi JO - Zhonghua Fu Chan Ke Za Zhi VL - 52 IS - 4 N2 - Objective: To investigate the clinical and pathological characteristics of atypical polypoid adenomyoma (APA) for improvement of the diagnosis, different diagnosis and treatment of the disease. Methods: The clinical data, pathological characteristics, and the follow-up information were retrospectively analyzed in 27 cases of APA admitted in Peking Univeristy People's Hospital from 2007 to 2016. Results: The median age was 42.6 years old (range 25-60 years old). Fifteen patients were nullipara, 2 patients were postmenopausal. The most common presenting symptom was abnormal uterine bleeding (81%, 22/27) . Leisions were obtained by using hysteroscopy in 23 cases, hysterectomy 3 cases and dilatation and curettage 1 case. Fertility preserving treatments were performed in 10 patients who had strong desire for fertility, among which 1 case progressed into endometrial carcinoma. Among 15 patients underwent hysterectomy and (or) bilateral salpingo-oophorectomy, 9 cases of them had endometrial atypical hyperplasia. Endometrial carcinoma along with APA were found in three patients, 2 cases of them underwent hysterectomy and bilateral salpingo-oophorectomy and pelvic lymphadenectomy, the other one received medication for fertility preservation. Follow up information were available in 24 cases (89%, 24/27) with a median follow up of 46 months (range 4-108 months), 1 case recurred and 1 case progressed into endometrial carcinoma. One case died of other malignancy, while the other patients were alive. Conclusions: APA is a rare uterine neoplasm mixed with epithelial and mesenchymal component. It occurs mostly in childbearing-age women and its diagnosis is dependent on pathology. Although it's clinical course is benign, there is risk of co-existance of endometrial carcinoma and endometrial atypical hyperplasia. For those who has desire of fertility, the treatment strategy is completely removed the lesion and closely followed up. For those who do not desire to preserve fertility, hysterectomy may be an option. SN - 0529-567X UR - https://www.unboundmedicine.com/medline/citation/28441840/[Atypical_polypoid_adenomyoma_of_the_uterus:_a_clinicopathological_review_of_27_cases]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&issn=0529-567X&year=2017&vol=52&issue=4&fpage=244 DB - PRIME DP - Unbound Medicine ER -