Zhou Y, Chen ZY, Zhang XM. Giant exophytic cystic adenomyosis with a levonorgestrel containing intrauterine device out of the uterine cavity after uterine myomectomy: A case report. World J Clin Cases 2020; 8(1): 188-193 [PMID: 31970186 DOI: 10.12998/wjcc.v8.i1.188]
Corresponding Author of This Article
Xin-Mei Zhang, PhD, Chief Doctor, Professor, Department of Gynecology, Women’s Hospital School of Medicine, Zhejiang University, No. 1, Xueshi Road, Hangzhou 310006, Zhejiang Province, China. zhangxinm@zju.edu.cn
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 6, 2020; 8(1): 188-193 Published online Jan 6, 2020. doi: 10.12998/wjcc.v8.i1.188
Giant exophytic cystic adenomyosis with a levonorgestrel containing intrauterine device out of the uterine cavity after uterine myomectomy: A case report
Yong Zhou, Zheng-Yun Chen, Xin-Mei Zhang
Yong Zhou, Zheng-Yun Chen, Xin-Mei Zhang, Department of Gynecology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Author contributions: Zhang XM, Zhou Y, and Chen ZY participated in the diagnosis and management of this case; Chen ZY and Zhou Y provided the figures; Zhou Y wrote the manuscript; Zhang XM revised and approved the version to be published.
Informed consent statement: Written informed written was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xin-Mei Zhang, PhD, Chief Doctor, Professor, Department of Gynecology, Women’s Hospital School of Medicine, Zhejiang University, No. 1, Xueshi Road, Hangzhou 310006, Zhejiang Province, China. zhangxinm@zju.edu.cn
Received: September 2, 2019 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
