Uterine intermural adenosarcoma arising from adenomyoma: A case report and review of literature
Rationale:
Intramural adenosarcoma of the uterine myometrium is an uncommon gynecologic malignancy, often diagnosed postoperatively, and may arise from pre-existing benign lesions such as adenomyoma.
Patient concerns:
A 46-year-old woman presented with irregular vaginal bleeding during the postmenstrual period for 3 months. She had a prior history of adenomyoma resection and breast cancer treated with tamoxifen.
Diagnoses:
Pelvic ultrasonography suggested multiple uterine myomas. Histopathological and immunohistochemical analyses of the resected specimen confirmed low-grade malignant uterine adenosarcoma originating from adenomyoma.
Interventions:
The patient underwent a lower abdominal hysterectomy with bilateral adnexectomy.
Outcomes:
Postoperative recovery was uneventful. No adjuvant therapy was administered, and the patient remains under regular oncology follow-up without recurrence to date.
Lessons:
This case highlights the potential for malignant transformation of adenomyoma into intramural adenosarcoma and underscores the importance of thorough histopathological evaluation in patients with recurrent or atypical uterine masses.