Year: 2020
Type: article
Study design: Case Report
Abstract: It is necessary to consider gynecologic malignancies when evaluating abnormal uterine bleeding (AUB), particularly in postmenopausal elderly women. We present herein a 90-year-old woman with serous cystic adenocarcinoma of the uterine myometrium in whom the pre-operative diagnosis was difficult to establish. She presented with AUB that had persisted for approximately 1 month. Uterine cervical and endometrial cytology, an endometrial biopsy, and a hysteroscopy revealed no evidence of malignancy. Transvaginal ultrasonography showed a 2-cm intramural fibroid-like tumor. Magnetic resonance imaging and positron emission tomography findings demonstrated a fibroid-like tumor that was suspicious for malignancy. The patient and her family requested AUB treatment rather than further evaluation and radical treatment of a malignant disease. Considering her age and the minimal invasiveness of laparoscopy, we performed a laparoscopic hysterectomy with bilateral salpingo-oophorectomy. The pathologic evaluation revealed serous cystic adenocarcinoma of the uterine myometrium. She did not desire further post-operative treatment, and therefore underwent periodic observation. When the cause of AUB was not identified based on usual office gynecologic examinations in postmenopausal elderly women, further imaging modalities should be considered to maximally rule out the presence of malignancy.
Authors: IWASAKI, Shinya, KAMATA, Mayumi, OSANAI, Hisato, HASHIMOTO, Masahiro, TATEOKA, Kazuhiro, MARUYAMA, Tetsuo
Institutions: Keio University, Shizuoka City Shimizu Hospital
Language: Japanese
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7208301663