Abscess in Adenomyosis Mimicking a Malignancy in a54-Year-Old Woman

[摘要] Background: Although there are a few reports describing abscess formation in endometriotic foci no report ofabscess formation arisingde novowithin adenomyosis appears in the literature. Preoperative diagnosisof adenomyosis is frequently difficult because of non-specific signs and symptoms. Synchronous pelvic pathologiessuch as leiomyoma, endometrial polyp, endometrial hyperplasia, as well as endometrial cancer may causedifferential diagnostic problems.Case: A 54-year-old postmenopausal woman complaining of inguinal pain, nightsweats and hot flashes ispresented. Radiologic examinations of the pelvis revealed a 95 × 85 mm leiomyoma-like lesion including a53 × 43 mmcystic space and 9 × 6 mmpapillary formation within the uterus raising clinical suspicion of malignancy.A total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed accompanied by afrozen section diagnosis. The frozen section revealed an abscess formation arising in a focus of adenomyosis.The postoperative period of the patient was uneventful.Conclusion: The present case, to our knowledge, is the first report representing abscess formation inadenomyosis. Abscess arising within adenomyosis can strongly raise the suspicion of endometrial cancer, particularlyif the patient is postmenopausal. If endometrial cancer cannot be ruled out with definitivehistopathological diagnosis in the preoperative period, a frozen section becomes mandatory during surgicalintervention.

[学科分类] 妇产科学