Paul's Hospital, Centre for Advanced Endoscopy & Infertility, Kochi, Kerala, India.
Eur J Obstet Gynecol Reprod Biol. 2018 Sep;228:130-136. doi: 10.1016/j.ejogrb.2018.06.021. Epub 2018 Jun 12.
Adenomyosis is the presence of endometrial glands and stroma within the myometrium. The focal and localized form of adenomyosis is known as adenomyoma. It is rarely located outside the uterus which is termed as extrauterine adenomyoma. We describe three cases of extrauterine adenomyomas which were located in pararectal space, round ligament and ovary. These cases were treated by laparoscopic excision and diagnosis was confirmed by histopathological examination. A review of the literature identified 34 cases of extrauterine adenomyomas. The most common locations were pararectal space, ovary and broad ligament. Other pelvic locations included the round ligament, paraovarian, parametrial and pelvic wall. Extrapelvic adenomyomas were located in the liver, upper abdomen, inguinal scar, appendix and small bowel mesentery. The abdominopelvic pain was the most common clinical presentation of extrauterine adenomyoma. Various imaging modalities were used to identify extrauterine masses, but a definitive diagnosis could not be made preoperatively in any of the cases. Although rare, a possible diagnosis of adenomyoma must be contemplated while dealing with extrauterine masses. Surgical excision is the mainstay of treatment. Since malignancy has been reported in extrauterine adenomyomas, this possibility must be kept in mind while offering treatment.
子宫腺肌病是指子宫内膜腺体和间质存在于子宫肌层中。局灶性和局限性的子宫腺肌病称为子宫腺肌瘤。它很少位于子宫外，称为子宫外腺肌瘤。我们描述了 3 例位于直肠旁间隙、圆韧带和卵巢的子宫外腺肌瘤。这些病例通过腹腔镜切除进行治疗，并通过组织病理学检查确诊。对文献的回顾确定了 34 例子宫外腺肌瘤。最常见的部位是直肠旁间隙、卵巢和阔韧带。其他盆腔部位包括圆韧带、副卵巢、子宫旁和骨盆壁。盆腔外的腺肌瘤位于肝脏、上腹部、腹股沟瘢痕、阑尾和小肠肠系膜。子宫外腺肌瘤最常见的临床表现是腹痛。各种影像学方法用于识别子宫外肿块，但在任何病例中均无法在术前做出明确诊断。虽然罕见，但在处理子宫外肿块时必须考虑到腺肌瘤的可能诊断。手术切除是主要的治疗方法。由于已经报道了子宫外腺肌瘤的恶性肿瘤，因此在提供治疗时必须考虑到这种可能性。
