Adenomatoid tumors (AT) arising in the female genital tract are usually incidental findings occurring most often in the fallopian tube and uterine serosa and rarely in the myometrium. In the myometrium, they appear grossly as deep seated, small, firm, ill circumscribed nodules mimicking leiomyoma. Histologically they show a glandular and invasive pattern making well-differentiated/low-grade endometrioid adenocarcinoma a major differential diagnosis. However, this differential is rarely encountered in practice because myometrial AT is usually seen on the hysterectomy specimen, because of their anatomic position in the deep myometrium, and only rarely in endometrial curettings. Our case is the first to report an AT, which presented as a polyp with associated fibroid on hysterescopic examination. Microscopically, the endometrial curetting and myomectomy showed irregular glands and cystic structures with occasional cytokeratin positive single signet-ring like cells invading into the myometrium, features consistent with low-grade endometrioid adenocarcinoma. On hysterectomy specimen, there was an ill-defined 5 cm mass in the myometrium with protrusion into the endometrium. The morphology was similar to that seen in the endometrial curetting. A larger panel of immunostains was done and the neoplastic cells were positive for AE1/3, CK7, CAM5.2, calretinin, and D2-40 and negative for CD34. A diagnosis of AT was rendered and no further treatment was required. Although AT is rarely seen in endometrial curetting, they should be in the differential diagnosis of glandular lesions to avoid pitfalls and unnecessary management especially in young patients desiring fertility.

中文翻译：

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子宫腺瘤样子宫内膜刮除术模拟子宫内膜样腺癌一例

发生于女性生殖道的腺瘤样肿瘤 (AT) 通常是偶然发现，最常见于输卵管和子宫浆膜，很少发生在子宫肌层。在子宫肌层中，它们大体上表现为与平滑肌瘤相似的深陷、小、坚硬、界限不清的结节。在组织学上，它们显示出腺体和侵袭性模式，使高分化/低级别子宫内膜样腺癌成为主要的鉴别诊断。然而，这种差异在实践中很少遇到，因为子宫肌层 AT 通常出现在子宫切除标本上，因为它们在深部子宫肌层中的解剖位置，很少见于子宫内膜刮除术。我们的病例是第一个报告 AT 的病例，其在宫腔镜检查中表现为息肉伴肌瘤。微观上，子宫内膜刮除术和子宫肌瘤切除术显示不规则腺体和囊状结构，偶见细胞角蛋白阳性单印戒样细胞侵入子宫肌层，特征与低级别子宫内膜样腺癌一致。在子宫切除术标本上，子宫肌层中有一个不明确的 5 cm 肿块，突出到子宫内膜中。形态与子宫内膜刮除术中所见相似。进行了更大的免疫染色，肿瘤细胞对 AE1/3、CK7、CAM5.2、钙视网膜蛋白和 D2-40 呈阳性，对 CD34 呈阴性。诊断为 AT，无需进一步治疗。虽然在子宫内膜刮除术中很少见到 AT，