EC Gynaecology

Adenomatoid tumors are rare, benign neoplasms that primarily affects the genital and urinary tracts. Only a few cases of myometrial adenomatoid tumors treated laparoscopically or in co-existence with endometriosis have been reported. Here we report a case of laparoscopically resected myometrial adenomatoid tumor with co-existing endometriosis and unusual histological features. A 30-year-old nulliparous woman with subfertility and ultrasound diagnosed uterine fibroid underwent laparoscopic excision of uterine mass and excision of endometriosis. Intra-op enucleation of the uterine tumor was challenging due to an ill-defined border between the lesion and surrounding normal myometrium. Histological features were misleading due to irregular proliferation of smooth muscle cells. The myometrial adenomatoid tumor displayed unusual features of large size, diffuse myometrial involvement with solid proliferation of mesothelial cells and possible serosal involvement, explaining the diagnostic and operative challenge.

 Keywords: Myometrial Adenomatoid Tumor; Adenomatoid Tumors; Leiomyomas; Endometriosis; Benign Tumor

1. Nogales FF., et al. “Adenomatoid tumors of the uterus: an analysis of 60 cases”. International Journal of Gynecological Pathology 1 (2002): 34-40.
2. Adorno FA., et al. “Leiomyoadenomatoid tumor of uterus: two case reports with literature review”. Surgical and Experimental Pathology 4 (2021): 5.
3. SM Lerias., et al. “Adenomatoid tumor of the uterus: a report of 6 unusual cases with prominent cysts including 4 with diffuse myometrial involvement, 4 with uterine serosal involvement, and 2 presenting in curettage specimens”. International Journal of Gynecological Pathology3 (2021): 248-256.
4. Kurman RJ., et al. “WHO classification of tumours of female reproductive organs”. WHO, Lyon (2014).
5. Amre R., et al. “Pathologic Quiz Case: A 52-Year-Old Woman with a Uterine Mass”. Archives of Pathology and Laboratory Medicine 3 (2005): e77-e78.
6. Sakurai N., et al. “Laparoscopically resected uterine adenomatoid tumor with coexisting endometriosis: Case report”. Journal of Minimally Invasive Gynecology2 (2011): 257-261.
7. Md Ali Osama., et al. “Adenomatoid tumor of fallopian tube with intratumoral endometriosis: what mind doesn't know, eyes don't see”. Journal of Laboratory Physicians (2023).
8. E JI. “Differential diagnosis in pathology: urologic disorders”. Igasku-Shoin, New York (1992): 173-174.
9. AJ Tiltman. “Adenomatoid tumors of the uterus”. Histopathology4 (1980): 437-443.