A case of atypical polypoid adenomyoma detected in endometrial polyps of an infertile woman after hysteroscopic resection

概要

論文の詳細を見る
Atypical polypoid adenomyoma (APAM) is an endometrial tumor that usually occurs in premenopausal women. APAM frequently recurs after resection, and coexists with or progresses to endometrial adenocarcinoma. Uterine conservative therapy is often selected for patients who desire to conceive, and several studies show good outcomes with conservative therapy. We report here a patient with APAM who achieved pregnancy and delivered a child with continuous infertility treatment after hysteroscopic resection of the tumor. The patient was a 34-year-old infertile woman. We performed hysteroscopic resection of multiple endometrial polyps for the purpose of infertility treatment, and found that a part of the polyps was APAM. After confirming that there was no remaining tumor in the uterus, we restarted infertility treatment. Endometrial cytology was performed at regular intervals and hysteroscopic resection was performed when a polypoid lesion was detected. She conceived after several cycles of infertility treatment, and delivered a healthy baby. No recurrence of APAM has been detected as of this writing. Consensus on a method of conservative treatment for APAM has not yet been achieved. It is necessary to assess the grade of malignancy and to perform careful follow-up after complete resection.