PDF(Pubmed)
Abstract：
BACKGROUND: Adenomyosis, a gynecological condition characterized by endometrial tissue within the uterine myometrium, often leads to menstrual pain and heavy bleeding, significantly affecting the quality of life. The primary treatment for adenomyosis and leiomyomas is hysterectomy. However, in rare instances, these conditions can recur in the cervical stump following a hysterectomy.Here, we present a case of cervical adenomyoma development after a prior laparoscopic supracervical hysterectomy.
METHODS: A 47-year-old woman sought medical attention due to increased vaginal bleeding.
METHODS: She had undergone a laparoscopic supracervical hysterectomy 7 years earlier to address uterine myoma and adenomyosis. Just 1 month posthysterectomy, a pelvic ultrasound revealed the presence of a cervical stump measuring approximately 4.0 × 4.0 cm. Subsequent follow-up ultrasounds documented the gradual growth of the cervical mass. Two years ago, a recurrent myoma was identified, and the patient experienced intermittent vaginal bleeding. Over 7 years, the cervical mass increased from 4 to 7 cm. Preadmission pelvic ultrasonography confirmed the existence of cervical adenomyoma measuring 7 × 6 cm.
METHODS: Consequently, the patient underwent a laparoscopic trachelectomy. Intraoperatively, an enlarged cervix, approximately 7 × 6 cm in size, containing adenomyoma was observed. A gross examination of the specimen indicated hypertrophic muscle tissue and hemorrhagic foci. Subsequent histopathological examination confirmed the presence of adenomyoma.
RESULTS: Remarkably, the patient exhibited no recurrence over the subsequent 8 months.
CONCLUSIONS: The case presented here highlights the potential occurrence of cervical adenomyoma following a supracervical hysterectomy. Management options include hormone therapy and surgical excision. Furthermore, annual follow-up comprising ultrasound and pap smear evaluations is recommended for patients with supracervical hysterectomies to detect and address possible recurrences.
METHODS: A 47-year-old woman sought medical attention due to increased vaginal bleeding.
METHODS: She had undergone a laparoscopic supracervical hysterectomy 7 years earlier to address uterine myoma and adenomyosis. Just 1 month posthysterectomy, a pelvic ultrasound revealed the presence of a cervical stump measuring approximately 4.0 × 4.0 cm. Subsequent follow-up ultrasounds documented the gradual growth of the cervical mass. Two years ago, a recurrent myoma was identified, and the patient experienced intermittent vaginal bleeding. Over 7 years, the cervical mass increased from 4 to 7 cm. Preadmission pelvic ultrasonography confirmed the existence of cervical adenomyoma measuring 7 × 6 cm.
METHODS: Consequently, the patient underwent a laparoscopic trachelectomy. Intraoperatively, an enlarged cervix, approximately 7 × 6 cm in size, containing adenomyoma was observed. A gross examination of the specimen indicated hypertrophic muscle tissue and hemorrhagic foci. Subsequent histopathological examination confirmed the presence of adenomyoma.
RESULTS: Remarkably, the patient exhibited no recurrence over the subsequent 8 months.
CONCLUSIONS: The case presented here highlights the potential occurrence of cervical adenomyoma following a supracervical hysterectomy. Management options include hormone therapy and surgical excision. Furthermore, annual follow-up comprising ultrasound and pap smear evaluations is recommended for patients with supracervical hysterectomies to detect and address possible recurrences.
摘要：
背景：子宫腺肌病，一种以子宫肌层内的子宫内膜组织为特征的妇科疾病，经常导致月经疼痛和大量出血，显著影响生活质量。子宫腺肌病和平滑肌瘤的主要治疗方法是子宫切除术。然而,在极少数情况下，子宫切除术后，这些情况可能会在宫颈残端复发。这里,我们介绍了1例宫颈腺肌瘤在腹腔镜下子宫切除术后发展的病例。
方法：一名47岁女性因阴道出血增加而求医。
方法：她在7年前接受了腹腔镜子宫上切除术，以治疗子宫肌瘤和子宫腺肌病。子宫切除术后一个月，盆腔超声显示存在大约4.0×4.0厘米的宫颈残端。随后的随访超声记录了宫颈肿块的逐渐生长。两年前,发现了一个复发性肌瘤,患者出现间歇性阴道出血。超过7年,宫颈肿块从4厘米增加到7厘米。入院前盆腔超声检查证实存在7×6cm的宫颈腺肌瘤。
方法：因此，该患者接受了腹腔镜下胆囊切除术。术中,扩大的子宫颈,尺寸约为7×6厘米，观察到含有腺肌瘤。标本的大体检查表明肥大的肌肉组织和出血性病灶。随后的组织病理学检查证实存在腺肌瘤。
结果：值得注意的是，患者在随后的8个月内未出现复发.
结论：这里介绍的病例强调了宫颈子宫切除术后宫颈腺肌瘤的潜在发生。管理选择包括激素治疗和手术切除。此外，建议对宫颈上子宫切除术患者进行包括超声和子宫颈抹片检查在内的年度随访,以发现和解决可能的复发.
方法：一名47岁女性因阴道出血增加而求医。
方法：她在7年前接受了腹腔镜子宫上切除术，以治疗子宫肌瘤和子宫腺肌病。子宫切除术后一个月，盆腔超声显示存在大约4.0×4.0厘米的宫颈残端。随后的随访超声记录了宫颈肿块的逐渐生长。两年前,发现了一个复发性肌瘤,患者出现间歇性阴道出血。超过7年,宫颈肿块从4厘米增加到7厘米。入院前盆腔超声检查证实存在7×6cm的宫颈腺肌瘤。
方法：因此，该患者接受了腹腔镜下胆囊切除术。术中,扩大的子宫颈,尺寸约为7×6厘米，观察到含有腺肌瘤。标本的大体检查表明肥大的肌肉组织和出血性病灶。随后的组织病理学检查证实存在腺肌瘤。
结果：值得注意的是，患者在随后的8个月内未出现复发.
结论：这里介绍的病例强调了宫颈子宫切除术后宫颈腺肌瘤的潜在发生。管理选择包括激素治疗和手术切除。此外，建议对宫颈上子宫切除术患者进行包括超声和子宫颈抹片检查在内的年度随访,以发现和解决可能的复发.
