Department of Ultrasound Medicine, the First People's Hospital of Linhai City, Linhai, China.
Department of Ultrasound Medicine, and State Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital School of Medicine Zhejiang University, Hangzhou, China.
J Int Med Res. 2024 Oct;52(10):3000605241282389. doi: 10.1177/03000605241282389.
Adenomatoid tumors are rare, specific, benign tumors of the reproductive tract that originate from mesenchymal tissue. A patient was diagnosed with uterine fibroids 1 year previously when a mass of approximately 30 mm was found in the left adnexal region during a physical examination. At 1 year of follow-up, ultrasound showed that the mass in the left adnexal area had greatly increased to 61 × 45 × 50 mm. Contrast-enhanced pelvic magnetic resonance imaging (MRI) was performed before surgery and suggested a borderline tumor. Histopathology suggested signet ring cell carcinoma, and an immunohistochemical examination suggested a uterine adenomatoid tumor. Our suspicion of a borderline tumor was based mainly on the following features: the mass had increased in size within 1 year, the cancer antigen 125 concentration had increased, and several lymph nodes in the pelvic and groin regions showed positive signals on MRI enhancement. Uterine adenomatoid tumors are challenging to diagnose, especially adenomatosis with signet ring cells. However, the accuracy of diagnosing this disease can be greatly improved by combining ultrasound and MRI. This article describes the most comprehensive and reliable imaging features of ultrasound and MRI, which play an important role in diagnosing uterine adenomatoid tumors and provide useful information for clinicians.
腺肌瘤样肿瘤是一种罕见的、特定的、来源于间叶组织的生殖系统良性肿瘤。患者 1 年前体检时发现左侧附件区有一约 30mm 的肿块，被诊断为子宫肌瘤。1 年后随访时，超声显示左侧附件区肿块明显增大至 61×45×50mm。术前行盆腔增强磁共振成像（MRI）检查提示交界性肿瘤。组织病理学提示印戒细胞癌，免疫组化检查提示子宫腺肌瘤样肿瘤。我们对交界性肿瘤的怀疑主要基于以下特征：肿块在 1 年内增大，癌抗原 125 浓度升高，盆腔和腹股沟区的几个淋巴结在 MRI 增强扫描时呈阳性信号。子宫腺肌瘤样肿瘤的诊断具有挑战性，特别是伴有印戒细胞的腺肌瘤样病变。然而，超声和 MRI 相结合可以大大提高对这种疾病的诊断准确性。本文描述了超声和 MRI 最全面、最可靠的影像学特征，这些特征对诊断子宫腺肌瘤样肿瘤具有重要作用，并为临床医生提供了有用的信息。
