Management of atypical polypoid adenomyoma of the uterus: A single center's experience

Atypical polypoid adenomyoma (APA) is a rare uterine lesion, which has a high rate of recurrence and malignant transformation. How to treat this disease is crucial for the prognosis, but there are few reports on it. We retrospectively reviewed the clinical records of all the patients diagnosed with APA after surgical therapy in our hospital. All the clinical information, pathological results, treatment, and outcome were retrieved from the clinical records. A total of 43 patients were diagnosed with APA. The median age was 56.0 years (range: 17–71 years). Primary treatments included hysteroscopic transcervical resection (TCR) of the lesions in 34 patients (79.1%), hysterectomy and bilateral salping-oophenrectomy in 5 (11.6%), hysterectomy in 1 (2.3%), and primary cytoreductive surgery for ovary cancer in 3. A total of 42 patients were followed up for a mean period of 26.9 months (range 2–57 months). Three of them recurred. One patient underwent hysterectomy after recurrence, and TCR was performed for the other 2. High-dose progestogen was given to the 2 recurrent patients after TCR. Hysterectomy is the primary therapeutic choice for postmenopausal patients with APA. Conservative treatment of APA with TCR is safe and efficient.