Vilos George A, Ettler Helen C
Departments of Obstetrics and Gynaecology, The University of Western Ontario, London, ON, Canada.
J Obstet Gynaecol Can. 2003 Sep;25(9):760-2. doi: 10.1016/s1701-2163(16)31005-2.
A 49-year-old woman presenting with menometrorrhagia underwent an office endometrial biopsy that indicated features suspicious for atypical polypoid adenomyoma (APA) but was inconclusive. The woman requested further evaluation prior to consenting to a hysterectomy and bilateral salpingo-oophorectomy. Hysteroscopy demonstrated a fleshy 2 cm to 3 cm sessile polypoid tumour, which was resected with the entire endometrium. The histology confirmed APA. Although amenorrhea was achieved, the gynaecological oncologist recommended the woman undergo hysterectomy, which she did 4 months later. Pathologic examination of the uterus revealed no residual endometrium or APA. As this tumour generally occurs in premenopausal women, and as conserving fertility potential may be an important consideration, hysteroscopic resection of such tumours may be a therapeutic option in women who wish to retain their uterus or who would be at high medical risk for hysterectomy. However, close, intermittent postoperative surveillance is recommended.
一名49岁的女性因月经过多前来就诊，接受了门诊子宫内膜活检，结果显示有非典型息肉样腺肌瘤（APA）的可疑特征，但结论不明确。该女性在同意进行子宫切除术和双侧输卵管卵巢切除术之前，要求进一步评估。宫腔镜检查发现一个2厘米至3厘米的肉质无蒂息肉样肿瘤，连同整个子宫内膜一起切除。组织学检查确诊为APA。尽管实现了闭经，但妇科肿瘤学家建议该女性进行子宫切除术，她在4个月后接受了手术。子宫的病理检查显示没有残留的子宫内膜或APA。由于这种肿瘤通常发生在绝经前女性中，并且保留生育潜力可能是一个重要的考虑因素，对于希望保留子宫或因子宫切除术存在高医疗风险的女性，宫腔镜切除此类肿瘤可能是一种治疗选择。然而，建议术后进行密切、间断的监测。
