Clinicopathological Analysis of 488 Cases of Endometrial Typical Polypoid Adenomyoma

OBJECTIVE: Endometrial typical polypoid adenomyoma (TPA) is an uncommon polypoid lesion. The pathogenesis of endometrium TPA is currently controversial. In this study the clinicopathological characteristics of 488 cases of endometrial TPA were retrospectively analyzed to clarify the pathogenesis and treatment of endometrial TPA. STUDY DESIGN: The clinicopathological characteristics of 488 cases of endometrial TPA were retrospectively analyzed, including patient age, body mass index, reproductive history, and pathological features. Furthermore, the pathogenesis and treatment of endometrial TPA were defined. RESULTS: 308 patients (63.11%) had abnormal vaginal bleeding; 142 patients (29.10%) had menstrual changes. The pathological manifestations were benign endometrial glandular proliferation and a special helical interlacing bundle of smooth muscle cells in the stroma around the gland. Among them, 149 cases were accompanied by abnormal endometrium hyperplasia. In 384 cases the transvaginal ultrasound revealed a strong or partial echo of the uterine cavity or cervical canal with a clear boundary. The most common lesion is located in the posterior wall (52.95%, 193/367). 66 cases were preoperatively diagnosed as submucosal myoma of the uterus, and 301 cases were preoperatively diagnosed as endometrial polyps. CONCLUSION: There was no apparent specificity in the clinical manifestations, transvaginal ultrasound, and tumor morphology of endometrial TPA. Pathological examination was the gold standard for a definitive diagnosis. High estrogen level, high estrogen receptor level, and endometrial injury were closely related to the occurrence of this disease. Hysteroscopic electrotomy was the preferential treatment for endometrial TPA.