Sonoyama Ayako, Kanda Masatoshi, Ojima Yojiro, Kizaki Tomohiko, Ohara Noriyuki
Department of Obstetrics and Gynecology, Sanda Municipal Hospital, Sanda, Japan.
Kobe J Med Sci. 2014 Dec 4;60(3):E74-7.
Atypical polypoid adenomyoma (APA) is a rare polypoid tumor of the uterus composed of atypical endometrial glands and smooth muscle cells. Concomitant development of endometrial adenocarcinoma in APA remains infrequent. We report a case of the coexistence of endometrioid adenocarcinoma in APA. A 41-year-old patient presented with abnormal genital bleeding. A polypoid mass was extruded from the external cervical os. She underwent transcervical resection of the polypoid mass arising from the lower uterine segment. Pathological examination revealed APA with the foci of well-differentiated endometrioid adenocarcinoma. Subsequently, she underwent total hysterectomy and bilateral salpingo-oophorectomy. No residual malignant lesions were found. Awareness of the close association of APA with the development of endometrial cancer is warranted. A meticulous pathological evaluation of specimen of APA is necessary for the detection of the coexistence of endometrial cancer.
非典型息肉状腺肌瘤（APA）是一种罕见的子宫息肉样肿瘤，由非典型子宫内膜腺体和平滑肌细胞组成。APA合并子宫内膜腺癌的情况仍不常见。我们报告一例APA合并子宫内膜样腺癌的病例。一名41岁患者出现生殖器异常出血。宫颈外口有一个息肉样肿物突出。她接受了经宫颈切除来自子宫下段的息肉样肿物。病理检查显示为APA，伴有高分化子宫内膜样腺癌灶。随后，她接受了全子宫切除及双侧输卵管卵巢切除术。未发现残留恶性病变。有必要认识到APA与子宫内膜癌发生的密切关联。对APA标本进行细致的病理评估对于检测子宫内膜癌的共存情况是必要的。
