Published online Jan 6, 2020. doi: 10.12998/wjcc.v8.i1.188
Peer-review started: September 2, 2019
First decision: November 13, 2019
Revised: November 28, 2019
Accepted: December 13, 2019
Article in press: December 13, 2019
Published online: January 6, 2020
Processing time: 126 Days and 11.5 Hours
A cystic lesion arising from the myometrium of the uterus, termed as cystic adenomyosis, has chocolate-like, thick viscous contents and contains various amounts of endometrial stroma below the glandular epithelium. It is an extremely rare type of adenomyosis.
Herein, we report an unusual case of a giant cystic mass in the pelvic cavity after uterine myomectomy. The patient complained of abnormal uterine bleeding and severe dysmenorrhea. After a levonorgestrel-containing intrauterine device (LNG-IUD) was inserted, her symptoms were greatly alleviated. However, the LNG-IUD was detected in the cystic cavity during the follow-up. For fear of the intrauterine device migrating into and damaging the surrounding viscera, surgical treatment was proposed. Therefore, laparoscopic resection of the lesion and removal of the LNG-IUD were performed and cystic adenomyosis with an LNG-IUD out of the uterine cavity was diagnosed.
We believe that myomectomy breaking through the endometrial cavity may have been a predisposing factor for the development of cystic adenomyosis in this case.
Core tip: Myomectomy breaking through the endometrial cavity may be a predisposing factor for the development of adenomyosis. A Mirena may provide effective therapeutic action for any pelvic endometrial deposit in different ways. In terms of management, laparoscopic uterine-sparing intervention may be a preferable choice for exophytic cystic adenomyosis.