Liu Weilong, Yao Tongtong, Wang Haiyan, Yu Wenjing, Shi Hongtang, Guo Jiwei, Liu Zhiqiang
Binzhou Medical University Hospital, Binzhou, Shandong, China.
Obstetrics and Gynecology, Liaocheng Women and Children Health, Liaocheng, Shandong, China.
BMC Womens Health. 2025 Jan 6;25(1):6. doi: 10.1186/s12905-024-03533-x.
Ovarian adenomyoma is a rare gynecological tumor with a high misdiagnosis rate, leading many patients to undergo unnecessary surgeries that may affect fertility. Menstrual abdominal pain is the most common symptom, and auxiliary examinations often cannot clarify its nature. It often relies on intraoperative diagnosis, and surgical resection can achieve good therapeutic effects.
A 50-year-old woman presented with lower abdominal pain during her menstrual period for the past two months. She had a previous medical history of uterine adenomyomectomy, ovarian cystectomy, and a cesarean section. Ultrasound revealed a 5.7 × 3.8 × 4.3 cm mass on the posterior wall of the uterus, a 9.9 × 5.6 × 8.2 cm hypoechoic mass in the right posterior part of the uterus, and a 2.8 × 2.2 × 2.7 cm anechoic mass in the left ovary. CA125 (Carbohydrate antigen 125) 191.80U/ml (0-30). MRI (magnetic resonance imaging) imaging confirmed a 7.9 × 6.2 × 7.2 cm fibroid on the right posterior wall of the uterus. Consider partial degeneration of multiple uterine fibroids and benign cystic degeneration in the lower left abdomen. Surgical resection was performed smoothly, and the diagnosis was confirmed by postoperative pathology.
Ovarian adenomyoma is a rare benign gynecologic tumour with a high rate of misdiagnosis. When a patient presents with recent lower abdominal pain or dysmenorrhea, a history of endometriosis or myomectomy, and MRI findings showing irregular bleeding patterns in a pelvic mass, the possibility of extrauterine adenomyosis should be considered. Minimally invasive treatment options, such as single-port laparoscopy or vaginal dissection, may offer advantages, but caution should be exercised due to the potential for malignant tumors. Preserving fertility is something worth exploring. We hope to provide warnings to more gynaecologists and reduce misdiagnosis and unnecessary treatment.
卵巢腺肌瘤是一种罕见的妇科肿瘤，误诊率高，导致许多患者接受了可能影响生育能力的不必要手术。痛经是最常见的症状，辅助检查往往无法明确其性质。常依靠术中诊断，手术切除可取得良好治疗效果。
一名50岁女性在过去两个月的月经期出现下腹痛。她既往有子宫腺肌病切除术、卵巢囊肿切除术和剖宫产史。超声显示子宫后壁有一个5.7×3.8×4.3厘米的肿块，子宫右后部有一个9.9×5.6×8.2厘米的低回声肿块，左卵巢有一个2.8×2.2×2.7厘米的无回声肿块。糖类抗原125（CA125）为191.80U/ml（0 - 30）。磁共振成像（MRI）检查证实子宫右后壁有一个7.9×6.2×7.2厘米的肌瘤。考虑多发性子宫肌瘤部分变性及左下腹良性囊性变。手术切除顺利，术后病理确诊。
卵巢腺肌瘤是一种罕见的良性妇科肿瘤，误诊率高。当患者近期出现下腹痛或痛经、有子宫内膜异位症或肌瘤切除术病史，且MRI检查发现盆腔肿块有不规则出血模式时，应考虑子宫外腺肌病的可能性。单孔腹腔镜或阴道剥离等微创治疗方案可能具有优势，但由于存在恶性肿瘤的可能性，应谨慎操作。保留生育功能值得探索。我们希望为更多妇科医生提供警示，减少误诊和不必要的治疗。
