Verta Stephanie, Brambs Christine E, Christmann Corina
Department of Obstetrics and Gynecology, Lucerne Cantonal Hospital, Lucerne, Switzerland.
Int J Womens Health. 2024 Mar 7;16:421-432. doi: 10.2147/IJWH.S450701. eCollection 2024.
Cystic adenomyomas (CA) are rare. They primarily affect adolescents and young women in their fertile years. Therefore, fertility and pregnancy outcome are of pivotal relevance in this patient collective. Apart from the guidelines of the European Society of Human Reproduction and Embryology (ESHRE) on the management of endometriosis in general, there are no specific treatment recommendations for CA and, as far as our research shows, no data illustrating the behavior of a CA over the course of pregnancy. Thus, we report the case of a 32-year-old 1-gravida, 1-para, preconceptionally diagnosed with a CA by ultrasound. After thoroughly discussing further treatment options, the decision was made to opt for a more conservative approach and not perform surgery before attempting a next pregnancy. The patient conceived spontaneously and sonographic monitoring of the CA throughout pregnancy showed complete regression of the cystic component during the second trimester. A healthy baby was delivered at term by an uncomplicated elective cesarean section. Following a review of the literature and taking into account the course of our case, we propose the feasibility of a conservative, non-surgical approach in women with a CA and the desire to conceive.
囊性腺肌瘤（CA）较为罕见。它们主要影响处于生育年龄的青少年和年轻女性。因此，生育能力和妊娠结局在这一患者群体中具有至关重要的意义。除了欧洲人类生殖与胚胎学会（ESHRE）关于子宫内膜异位症总体管理的指南外，目前尚无针对CA的具体治疗建议，而且据我们的研究表明，也没有数据说明CA在妊娠过程中的表现。因此，我们报告一例32岁、孕1产1的患者，孕前经超声诊断为CA。在充分讨论进一步的治疗方案后，决定选择更保守的方法，在尝试下次怀孕前不进行手术。患者自然受孕，孕期对CA进行超声监测显示，在孕中期囊性成分完全消退。足月时通过无并发症的择期剖宫产分娩出一个健康的婴儿。在回顾文献并考虑我们病例的过程后，我们提出对于有CA且有生育意愿的女性，采用保守的非手术方法是可行的。
