Atypical Polypoid Adenomyoma Coexistent with Atypical Endometrial Hyperplasia Treated with Hysteroscopic Transcervical Resection: Case Report

Abstract

  An atypical polypoid adenomyoma (APAM) is a benign mixed epithelial and mesenchymal tumor. Histologically, an APAM features a biphasic proliferation of atypical endometrial glands within myofibromatous stroma. To emphasize the potential risk for myometrial invasion, APAM with markedly complex glands is designated "atypical polypoid adenomyoma of low malignant potential" (APA-LMP). We report a case of a 27-year-old infertile woman with an atypical polypoid adenomyoma coexistent with atypical endometrial hyperplasia. She underwent hysteroscopic transcervical resection followed by medroxyprogesterone acetate therapy. After a complete response was achieved, she received clomiphene therapy and subsequently underwent in vitro fertilization-embryo transfer (IVF-ET). Although APAM is a benign tumor, a persistent lesion or recurrence is frequently observed. Occasionally, APAM coexists with endometrial hyperplasia or carcinoma. Clinical management of APAM has not been elucidated; however, fertility conservation should be considered if it is followed by careful observation.