Department of Health Sciences University of Leicester and University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, United Kingdom,
Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.
Gynecol Obstet Invest. 2019;84(6):521-547. doi: 10.1159/000499019. Epub 2019 Mar 19.
We reviewed published cases of uterus-like mass (U-LM), endomyometriosis, polypoid adenomyoma (PA), adenomyomatous polyp, atypical PA (APA), and adenomyoma.
PubMed, Medline, and Scopus searches of all cases published in the databases till November 26, 2018.
We identified 45 case reports of U-LM in the pelvis, 10 cases of endomyometriosis, 44 cases of adenomyomatous polyp, 466 cases of APA and case series of adenomyoma and PA. Most case reports focused on histological description of removed lesions with no or very limited clinical correlates. Histological descriptions were often used interchangeably, which creates considerable confusion. It is unclear if endomyometriosis warrants inclusions as a distinct entity, since the distinction is blurred between adenomyomatous polyp and PA. The glandular epithelium in atypical polypoid adenomyoma exhibits atypia and the lesions have a tendency to recur with a risk of malignant transformation. Smooth muscle metaplasia and Müllerian fusion defects have been proposed as etiology, but it is possible that the lesions do not share a common origin.
There is need for more detailed and structured description of reported cases including clinical presentation and associated pathology.
我们复习了已发表的子宫样肿块(U-LM)、子宫内膜异位症、息肉状腺肌瘤(PA)、腺肌瘤性息肉、非典型 PA(APA)和腺肌瘤病例。
在 PubMed、Medline 和 Scopus 数据库中对截至 2018 年 11 月 26 日发表的所有病例进行检索。
我们共发现 45 例盆腔 U-LM、10 例子宫内膜异位症、44 例腺肌瘤性息肉、466 例 APA 和腺肌瘤及 PA 的病例系列报道。大多数病例报告侧重于切除病变的组织学描述,几乎没有或只有很少的临床相关性。组织学描述经常被交替使用,这造成了相当大的混乱。目前尚不清楚子宫内膜异位症是否需要作为一个独立的实体纳入其中,因为腺肌瘤性息肉和 PA 之间的界限比较模糊。非典型息肉状腺肌瘤中的腺体上皮具有异型性,并且这些病变具有复发和恶变的倾向。平滑肌化生和 Müllerian 融合缺陷被认为是其病因,但这些病变可能没有共同的起源。
需要对报道的病例进行更详细和结构化的描述,包括临床表现和相关病理学。