Abstract:

Cystic adenomyosis is a rare type of adenomyosis. We report a case of asymptomatic cystic adenomyosis in submucosa diagnosed and treated by hysteroscopy. In this case, the patient had no obvious clinical symptoms although the lesion protruded to the uterine cavity. Preoperative B-ultrasound repeatedly suggested abnormal manifestations in the uterine wall or uterine cavity. Two submucosal lesions were found only when the pressure of distention was reduced during hysteroscopy. The bottom wall of the cyst was preserved as part of the endometrium during treatment, followed by 3 months of sequential estrogen progesterone therapy. The pregnancy outcome was achieved through in vitro fertilization-embryo transfer. Through the retrospective analysis of this special case, we can deepen the understanding and diagnosis of cystic adenomyosis of uterus in a special location. When the abnormal manifestations of uterine wall or uterine cavity are repeatedly indicated by B-ultrasound, but no obvious abnormalities are found by hysteroscopy, the possibility of submucosal cystic adenomyosis should be considered, and the intrauterine lesions should be observed after the intrauterine pressure is reduced. In the treatment process, "fenestration" can also be adopted, followed by sequential therapy of estrogen plus progesterone to improve the pregnancy outcome.

Key words: Adenomyosis, Diagnosis, Therapy, Cystic adenomyosis of uterus