Medical College of Wisconsin (Kerschner).
Department of Obstetrics and Gynecology (Dr. Briggs).
J Minim Invasive Gynecol. 2023 Jul;30(7):593-595. doi: 10.1016/j.jmig.2023.03.009. Epub 2023 Mar 21.
Tubulovillous adenomas are colonic polyps with a relatively high potential for malignancy that are typically identified on colonoscopy. We present a case of colonic tubulovillous adenoma first discovered on gynecologic transvaginal ultrasound. The patient was a 42-year-old gravida 2 para 2 female with symptoms suggestive of endometriosis, including left lower quadrant pain, heavy menstrual bleeding, urinary urgency, and dyschezia. The patient underwent transvaginal ultrasound following the International Deep Endometriosis Analysis protocol that identified an intermediate echogenicity, vascular solid mass of the rectosigmoid lumen. Consequent colonoscopy and polypectomy revealed tubulovillous tissue negative for high-grade dysplasia or malignancy. This case report highlights the importance of gynecologists developing an acute awareness of colonic pathologies that might be encountered while performing endometriosis ultrasounds with direct assessment of the rectum.
管状绒毛状腺瘤是一种具有较高恶性潜能的结肠息肉，通常在结肠镜检查时发现。我们报告一例首次在妇科经阴道超声检查中发现的结肠管状绒毛状腺瘤。患者为 42 岁经产妇，有子宫内膜异位症的症状，包括左下腹疼痛、月经过多、尿急和排便困难。患者按照国际深部子宫内膜异位症分析方案进行经阴道超声检查，发现直肠乙状结肠管腔内中等回声、血管实性肿块。随后进行的结肠镜检查和息肉切除术显示管状绒毛状组织无高级别异型增生或恶性病变。本病例报告强调了妇科医生在进行子宫内膜异位症超声检查时，直接评估直肠，应敏锐意识到可能遇到的结肠病变的重要性。
