A case of uterine adenomyoma of endocervical type that was suspected as minimal deviation adenocarcinoma on biopsy, MRI findings, and literature review

Takahiro Yamamoto, MD; Yu Koshikawa, MD; Mayako Yamaji, MD, PhD; Shuji Ikeda, MD, PhD; Ayaka Ishikawa, MD, PhD; Akihiko Wakatsuki, MD, PhD; Akira Satou, MD, PhD; Kojiro Suzuki, MD, PhD

Radiology Case Reports (Aug 2024)

A case of uterine adenomyoma of endocervical type that was suspected as minimal deviation adenocarcinoma on biopsy, MRI findings, and literature review

Takahiro Yamamoto, MD,
Yu Koshikawa, MD,
Mayako Yamaji, MD, PhD,
Shuji Ikeda, MD, PhD,
Ayaka Ishikawa, MD, PhD,
Akihiko Wakatsuki, MD, PhD,
Akira Satou, MD, PhD,
Kojiro Suzuki, MD, PhD

Affiliations

Takahiro Yamamoto, MD: Department of Radiology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, Japan; Corresponding author.
Yu Koshikawa, MD: Department of Radiology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, Japan
Mayako Yamaji, MD, PhD: Department of Radiology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, Japan
Shuji Ikeda, MD, PhD: Department of Radiology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, Japan
Ayaka Ishikawa, MD, PhD: Department of Obstetrics and Gynecology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, Japan
Akihiko Wakatsuki, MD, PhD: Department of Obstetrics and Gynecology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, Japan
Akira Satou, MD, PhD: Department of Surgical Pathology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, Japan
Kojiro Suzuki, MD, PhD: Department of Radiology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, Japan

Journal volume & issue: Vol. 19, no. 8
pp. 3268 – 3272

Abstract

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Uterine adenomyomas of endocervical type are rare benign tumors of the uterine cervix commonly presented as cyst-like, dilated glandular structures within polypoid masses. A premenopausal woman in her 50s was referred to our hospital because of an increasing watery vaginal discharge. A multifocal cyst measuring 5 × 4.5 cm in size projecting into the endocervical canal was revealed on a contrast-enhanced MRI. The fluid within the tumor showed a hypointense signal on T1-weighted imaging (T1WI) and a hyperintense signal on T2-weighted imaging (T2WI). On T2WI, most of the septa within the tumor showed a slightly hyperintense to hypointense signal, whereas some areas revealed a strong hypointense signal; the contrast effect on the septum was satisfactory. On the T2WI taken 2 years previously, the tumor was a 4.5 × 3.5 cm polypoid mass protruding from the posterior endocervical wall. Contrastingly, the current T2WI showed that the stem was no longer identifiable because of tumor growth. Because previous imaging showed that the tumor was a stalked tumor protruding from the posterior endocervical wall, the imaging diagnosis was uterine adenomyoma of the endocervical type. A biopsy suggested the possibility of a minimal deviation adenocarcinoma (MDA). Hence, a total hysterectomy was performed. The final diagnosis confirmed the uterine adenomyoma of endocervical type. Uterine adenomyoma of the endocervical type might be difficult to differentiate from MDA in small biopsy specimens; therefore, evaluation of morphology by MRI is considered important in preoperative diagnosis.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: http://www.journals.elsevier.com/radiology-case-reports/

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