INTRALİGAMENTER ADENOMYOMA

Abstract

Adenomyozis, endometrial gland ve stroma yapısının myometriumda bulunması halidir. Lokalize formuna adenomyom denilir ve adenomyomlar leiomyomu taklit eder. Ekstrauterin adenomyom literatürde vaka sunumları olarak yer alan ve oldukça nadir görülen bir antitedir. Patolojilerinde endometrial mukoza ile döşeli santral bir kavite ve çevresinde myometrium dokusundan kalın bir duvar yapısı ile uterus benzeri kitle görünümü vardır. Ekstrauterin adenomyomlar, over, broad ligament, uterosakral ligamant ya da ekstrapelvik lokalizasyonlu olabilirler. Etyopatojenezinden müllerian kanal kapanma defekti ve subçölomik mezanşimal transformasyon sorumlu tutulmaktadır. Bu yazıda, 37 yaşında primer infertil hastada sol adneksiyal kitle nedeniyle yapılan laparoskopi sırasında ligamantum latum yaprakları arasında tespit edilen ve histopatolojik olarak ekstrauterin adenomyom tanısı alan olgu tartışılmıştır. Ayırıcı tanıda endometrioma, leiomyomatozis peritonealis, leiomyomlar, maliniteler yer almalıdır. Nadir görülse de adneksiyal kitlelerin ayırıcı tanısında ekstrauterin adenomyomlar akla gelmelidir.

Keywords

• Adenomyozis,broad ligament,mezanşimal transformasyon

INTRALIGAMENTARY ADENOMYOMA

Abstract

Adenomyosis is the presence of endometrial glands and stroma within the endometrium. Its localised form is called adenomyoma and adenomyomas mimic leiomyomas. An extrauterine adenomyoma is an extremely rare entity and take a place in the literature as case reports. Uterus like masses with thick muscle wall and endometrium-lined central cavity are seen in their pathology. Extrauterin adenomyomas can be located in ovary, broad ligament, uterosacral ligament or extrapelvic localisation. Müllerian duct fusion defect and subcoelomic mesenchyme transformation are two possible theory for etiopathogenesis of extrauterine adenomyoma. Herein, we discussed a patient 37 years old with primary infertility which was operated for left adnexial mass and detected intraligamentary mass during laparoscopy. The diagnosis was confirmed as extrauterine adenomyoma with histopathological examination. Differantial diagnosis should be done with endometrioma, leiomyomatosis peritonealis, leiomyomas and malignancies. Althought it is an extremely rare entity, extrauterine adenomyomas should be included in differential diagnosis of adnexal masses.

Keywords

• Adenomyosis,broad ligament

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