Adenosarcoma of an endometrial polyp in a 27-year-old nulligravida: a case report.
BACKGROUND
Endometrial adenosarcoma is a rare tumor first described by Clement and Scully in 1974. It consists of benign or atypical neoplastic glands within a sarcomatous stroma and represents approximately 8% of all uterine sarcomas. Patients of a variety of ages are affected: the largest series reported 100 cases in patients aged 14-89 years, with the median age at presentation 58 years. Other case reports identified on a literature search also describe patients within this age range. The typical presentation is symptoms of abnormal vaginal bleeding. On examination, tissue protruding from the external cervical os is a common finding, with a smaller number of patients having an enlarged uterus or palpable pelvic mass. The standard management is total abdominal hysterectomy and bilateral salpingo-oophorectomy. However, difficulty arises when one is faced with this condition in a young nullipara wishing to preserve her fertility.


METHODS
Endometrial polyp adenosarcoma occurred in a 27-year-old, nulligravid woman who presented with intermenstrual and postcoital bleeding. She was managed conservatively but will require close followup subsequently.


CONCLUSIONS
A clinical dilemma was encountered in the management of a young woman with endometrial polyp adenosarcoma because of the necessity to preserve her fertility.
Abu
Jafaru
J
Department of Obstetrics and Gynaecology, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
Ireland
David
D
Brown
Laurence
L
D018195:Adenosarcoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005298:Fertility / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D011127:Polyps / Q000473:pathology / Q000601:surgery*; D013997:Time Factors