Objectives: To propose a therapeutic approach and follow-up of patients with atypical polypoid adenomyoma (APA) wishing to remain fertile.
Patients and method: We are presenting a retrospective study of eight APA cases.
Results: Two patients immediately received radical treatment, and one patient had an endometrial thermocoagulation. The remaining five patients received a conservative treatment with ultrasound and hysteroscopic monitoring. Among them, two had full-term pregnancies, one is being treated for infertility, in one case, the APA disappeared after three hysteroscopy-curettages and macroprogestative treatment. Lastly, one of our patients died from an aggressive endometrioid ovarian bilateral tumour associated with an endometrial adenocarcinoma.
Discussion and conclusion: Radical treatment is necessary for cases of APA in women no longer wishing to remain fertile. For those wishing to remain fertile, we can offer a conservative treatment once they have been informed regarding the associated risk of relapse, degeneration, and ovarian lesions which necessitate stricter follow-up.
Keywords: Adénocarcinome endométrial; Adénomyome polypoïde atypique; Atypical polypoid adenomyoma; Conservative treatment; Endometrial adenocarcinoma; Infertility; Infertilité; Traitement conservateur.
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