Imaging Features of Rare Ovarian Adenomyoma

Abstract

A 42-year-old single woman presented to the Department of Gynecology with irregular vaginal bleeding with blood clots for the previous 2 months. She had no abdominal pain. Since the onset of symptoms, she had remained cheerful, and her general physical condition had not changed significantly. She reported no history of sexual activity, surgical procedures, or trauma. Tumor markers, including alpha-fetoprotein, carcinoembryonic antigen, CA19-9, and CA15-3, were within normal limits, with the exception of a mildly elevated serum CA125 concentration of 37.34 U/mL. All other laboratory tests returned normal results. Magnetic resonance imaging revealed a mass with both cystic and solid components in the left adnexal area. The mass was Grade 3 according to the Ovarian-Adnexal Reporting and Data System. Its features are shown in Figure 1. There was no evidence of invasion of the surrounding organs or retroperitoneal lymphadenopathy. The final pathological diagnosis was ovarian adenomyoma as evidenced by tubal metaplasia of the endometrium with some edema (Figure 2). The patient was discharged from the hospital in good condition after surgery.

Ovarian adenomyoma, a rare benign tumor of the female reproductive system, was first reported in 1981. The mechanism of the development of extrauterine adenomyomas is unclear. The main symptom of ovarian adenomyomas is abdominal pain, which may be related to endometriosis. The imaging features of ovarian myomas vary considerably, the differential diagnosis being granulosa cell tumor, fibrothecoma, and cystadenoma. The following features support a diagnosis of ovarian adenomyoma. First, the presence of endometriosis or a history of pelvic surgery, including cesarean section. Second, the solid component of the mass shows marked enhancement. Finally, the diffusion sequence of the mass is not limited.

Haitao Liu: writing–original draft (Lead). Weishun Lan: writing–review and editing.

Approval from our institutional ethics committee was not required because this was a retrospective observational study.

The patient provided written informed consent at the time of entering this study.

The authors declare no conflicts of interest.