Fertility-sparing management of atypical polypoid adenomyoma in a premenopausal woman: a two-case report and literature review

IF 2.7

AJOG global reports Pub Date : 2026-02-01 Epub Date: 2025-11-27 DOI:10.1016/j.xagr.2025.100589

Ivo Vukasović MD , Dinka Pavičić Baldani MD, PhD , Lana Škrgatić MD, PhD , Magdalena Karadža MD, PhD

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引用次数: 0

Abstract

Objective

To describe fertility-sparing management of atypical polypoid adenomyoma (APA) in two premenopausal women and to review the relevant literature on treatment strategies aimed at preserving fertility.

Case Report

A 39-year-old nulliparous woman presented with heavy menstrual bleeding and was diagnosed with APA via hysteroscopy and histopathology. Rapid recurrence prompted a second-look hysteroscopy and complete lesion resection. The second case involved a 30-year-old nulliparous woman with prolonged bleeding and a suspected submucosal fibroid; hysteroscopic resection confirmed APA. She received a levonorgestrel-releasing intrauterine device and regular follow-up. Both cases highlight diagnostic and therapeutic challenges in managing APA while preserving fertility.

Conclusion

These cases illustrate the diagnostic and therapeutic challenges of APA while preserving fertility. Based on our cases and a review of the literature, complete hysteroscopic resection, combined with hormonal therapy when appropriate, may be effective. Close follow-up is essential due to the risk of recurrence and potential malignant transformation, and individualized management is recommended to optimize fertility outcomes.

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不典型息肉样腺肌瘤在绝经前妇女的生育保留管理：两例报告和文献复习

目的介绍2例绝经前妇女不典型息肉样腺肌瘤（APA）的保留生育能力的治疗方法，并回顾有关保留生育能力的治疗策略的相关文献。病例报告一名39岁未生育妇女，经宫腔镜和组织病理学诊断为APA。快速复发促使二次宫腔镜检查和完全切除病变。第二个病例涉及一名30岁的未生育妇女，长期出血和疑似粘膜下纤维瘤；宫腔镜切除证实APA。她接受了左炔诺孕酮释放宫内节育器和定期随访。这两个病例都突出了在保持生育能力的同时管理APA的诊断和治疗挑战。结论这些病例说明了在保留生育能力的情况下，APA的诊断和治疗面临的挑战。根据我们的病例和文献回顾，完全宫腔镜切除，适当时结合激素治疗可能是有效的。由于复发和潜在恶性转化的风险，密切随访是必要的，建议个体化管理以优化生育结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AJOG global reports Endocrinology, Diabetes and Metabolism, Obstetrics, Gynecology and Women's Health, Perinatology, Pediatrics and Child Health, Urology

CiteScore

1.20

自引率

0.00%

发文量