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Case Reports
. 2022 Mar 3:9:764523.
doi: 10.3389/fmed.2022.764523. eCollection 2022.

Ultrasound-Guided Transvaginal Aspiration and Sclerotherapy for Uterine Cystic Adenomyosis: Case Report and Literature Review

Xinxin Zhao  1 , Ye Yang  2
Affiliations
Case Reports

Ultrasound-Guided Transvaginal Aspiration and Sclerotherapy for Uterine Cystic Adenomyosis: Case Report and Literature Review

Xinxin Zhao et al. Front Med (Lausanne). .

Abstract

Background: Uterine cystic adenomyosis is a very rare type of adenomyosis which can be easily misdiagnosed in clinical practice. In the past, cases have been mostly treated with surgical resection of the uterine lesion.

Case presentation: We report the case of a 25-year-old woman who presented with severe dysmenorrhea for more than 1 year. Physical examination showed that the uterus was enlarged. The transvaginal ultrasound showed a cystic mass of about 5.0 × 3.6 × 3.6 cm in the posterior myometrium, with dense echo spots and no blood flow signal in the cystic part. Magnetic resonance imaging (MRI) indicated hemorrhages within the cystic mass, suggesting the possibility of uterine cystic adenomyosis. The lower abdominal pain and severe dysmenorrhea were not alleviated after a 6-month trial of oral contraceptives. Subsequently, she underwent ultrasound-guided transvaginal aspiration and sclerotherapy for uterine cystic adenomyosis. Approximately 90 mL of chocolate-colored fluid was aspirated from the mass and 20 mL of lauromacrogol was injected in the cyst. The reduction rates of the mass 3 and 12 months after the procedure were 92.01 and 99.10%, respectively. Her dysmenorrhea completely resolved. One and half year after the operation, she had a successful pregnancy and gave birth to a healthy baby through vagina.

Conclusion: The rare entity of uterine cystic adenomyosis can be treated safely and effectively by ultrasound-guided transvaginal aspiration and sclerotherapy.

Keywords: adenomyosis; aspiration; cystic adenomyosis; sclerotherapy; ultrasound; uterine tumor.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Transvaginal ultrasound showed a cystic mass (vertical arrow) in the posterior myometrium, accompanied by dense echo spots. The uterine cavity (horizontal arrow) did not communicate with the mass.
Figure 2
Figure 2
The mass (horizontal arrow) showed hyperintense signal on T-2 weighted Magnetic resonance imaging (MRI) image. It was protruding outward compressing the endometrium but not communicating with the uterine cavity.
Figure 3
Figure 3
Transvaginal ultrasound showed that the mass (horizontal arrow) was significantly decreased 1 year after operation, with moderate echo and no fluid collection.
See this image and copyright information in PMC

References

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