title: Hysteroscopic treatment of atypical polypoid adenomyoma diagnosed incidentally in a young infertile woman.
abstract: OBJECTIVE
  To describe the conservative treatment of an atypical polypoid adenomyoma (APA) in a young infertile patient using a modification of the technique previously reported for the conservative treatment of stage IA endometrial cancer.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Department of Gynaecology and Obstetrics and Pathophysiology of Human Reproduction of the University of Naples "Federico II."
  
  
  METHODS
  A 35-year-old woman diagnosed incidentally with an APA during routine investigation for primary infertility.
  
  
  METHODS
  Conservative resectoscopic treatment using a four-step technique in which each step is characterized by a pathological analysis: the removal of the APA (step 1), the removal of endometrium adjacent to the APA (step 2), the removal of the myometrium underlying the APA (step 3), and multiple random endometrial biopsies (step 4).
  
  
  METHODS
  Complete resection of the APA and ruling out of any malignancy.
  
  
  RESULTS
  The conservative surgery was effective as histological examination of all specimens confirmed an APA confined to the endometrium without any other premalignant or malignant lesion. Transvaginal ultrasound and office hysteroscopy with target biopsies at 1 and 6 months after surgery were negative for atypia and malignancy.
  
  
  CONCLUSIONS
  Our technique under a close, intermittent postoperative surveillance might represent a good therapeutic option for those women with APA who wish to preserve their fertility as well as for those at high medical risk for hysterectomy.
authors: Department of Gynaecology and Obstetrics, University of Naples Federico II, Naples, Italy. cdispie@tin.it
authors: Attilio
authors: A
authors: Di Spiezio Sardo
authors: Ivan
authors: I
authors: Mazzon
authors: Virginia
authors: V
authors: Gargano
authors: Costantino
authors: C
authors: Di Carlo
authors: Maurizio
authors: M
authors: Guida
authors: Chiara
authors: C
authors: Mignogna
authors: Giuseppe
authors: G
authors: Bifulco
authors: Carmine
authors: C
authors: Nappi
mesh_terms: D018194:Adenomyoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D000328:Adult; D000465:Algorithms; D016889:Endometrial Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D033162:Incidental Findings; D007247:Infertility, Female / Q000209:etiology*; D008954:Models, Biological