Work

Fertility-sparing management of atypical polypoid adenomyoma in a premenopausal woman: a two-case report and literature review

Year: 2025

Type: article

Abstract: Objective: To describe fertility-sparing management of atypical polypoid adenomyoma (APA) in two premenopausal women and to review the relevant literature on treatment strategies aimed at preserving fertility. Case Report: A 39-year-old nulliparous woman presented with heavy menstrual bleeding and was diagnosed with APA via hysteroscopy and histopathology. Rapid recurrence prompted a second-look hysteroscopy and complete lesion resection. The second case involved a 30-year-old nulliparous woman with prolonged bleeding and a suspected submucosal fibroid; hysteroscopic resection confirmed APA. She received a levonorgestrel-releasing intrauterine device and regular follow-up. Both cases highlight diagnostic and therapeutic challenges in managing APA while preserving fertility. Conclusion: These cases illustrate the diagnostic and therapeutic challenges of APA while preserving fertility. Based on our cases and a review of the literature, complete hysteroscopic resection, combined with hormonal therapy when appropriate, may be effective. Close follow-up is essential due to the risk of recurrence and potential malignant transformation, and individualized management is recommended to optimize fertility outcomes.

Source: AJOG Global Reports

DOI: 10.1016/j.xagr.2025.100589

Authors: Ivo Vukasović, Dinka Pavičić Baldani, Lana Škrgatić, Magdalena Karadža

Institutions: University Hospital Centre Zagreb, University of Zagreb

Language: English

Topic: Uterine Myomas and Treatments

Subfield: Obstetrics and Gynecology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,980