Abu Atileh Luay Ibrahim, Khalifeh Nouf, Sabanekh Caroline, Amairi Lina, Al Omari Bayan
Istishari Hospital, Amman, Jordan.
Department of Obstetrics and Gynaecology, Augusta Hospital, Bochum, Germany.
Gynecol Minim Invasive Ther. 2025 May 22;14(2):185-188. doi: 10.4103/gmit.GMIT-D-24-00026. eCollection 2025 Apr-Jun.
We report a case of a pedunculated adenomyoma with osseous metaplasia, which mimics a dermoid cyst on magnetic resonance imaging (MRI) making it a considerable differential diagnosis. A 40-year-old female presented with chronic lower abdomen pain for a year. Pelvic MRI revealed a right-sided pelvic mass measuring 8.4 cm × 5.7 cm. The mass appeared isointense, with hyperintense contents similar to calcifications and fatty content. These results strongly indicated a dermoid cyst. During laparoscopy, a massive pedunculated uterine myoma was seen on the right posterior-fundal part of the uterus. During laparoscopic myomectomy, calcified tissues were discovered during manual morcellation. The histopathological examination confirmed the diagnosis of adenomyoma with widespread calcification and localized osseous metaplasia. Osseous metaplasia is an uncommon cytomorphological transformation seen mostly in the endometrium. Adenomyomas are rare, benign uterine tumors that are frequently misdiagnosed. In this case, the preoperative diagnosis suggested a dermoid cyst, broadening the differential diagnosis for calcified uterine tumors detected on MRI.
我们报告一例带蒂的伴有骨化生的腺肌瘤病例，该病例在磁共振成像（MRI）上类似皮样囊肿，这使其成为一个需要重点鉴别的诊断。一名40岁女性因慢性下腹痛就诊一年。盆腔MRI显示右侧盆腔有一大小为8.4 cm×5.7 cm的肿块。该肿块呈等密度，其内容物呈高信号，类似于钙化和脂肪成分。这些结果强烈提示为皮样囊肿。腹腔镜检查时，在子宫右后底部可见一个巨大的带蒂子宫肌瘤。在腹腔镜子宫肌瘤切除术中，手动粉碎肌瘤时发现了钙化组织。组织病理学检查确诊为伴有广泛钙化和局部骨化生的腺肌瘤。骨化生是一种罕见的细胞形态学转变，多见于子宫内膜。腺肌瘤是罕见的良性子宫肿瘤，常被误诊。在本病例中，术前诊断提示为皮样囊肿，拓宽了MRI检测到的钙化子宫肿瘤的鉴别诊断范围。
