子宮鏡下経頸管的切除術後、二期的に腹腔鏡下子宮全摘術を施行したポリープ状異型腺筋腫の一例

抄録

  Atypical polypoid adenomyoma (APAM) is a rare uterine tumor that occurs predominantly in premenopausal women. The clinical management of APAMs remains to be established. We report the case of a 46-year-old nulliparous patient who underwent hysteroscopic transcervical resection (TCR) for an atypical polypoid adenomyoma or adenofibroma. As the cervical myoma involved the uterus, the tumor (3.6×2.4 cm) could not be resected completely because of the risk of perforation of the uterus. The patient chose watchful waiting instead of our advice of hysterectomy or further treatment. The residual tumor measured 3.8×1.5 cm after TCR and had grown to 4.8×1.0 cm 6 months later. Furthermore, endometrial biopsy revealed that the APAM had low malignant potential. Subsequently, she underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy. The final diagnosis was APAM.