Laparoscopic excision of uterine adenomatoid tumour: two cases and literature review

Adenomatoid tumours are rare, benign neoplasms of the genital tract, occurring most commonly during the reproductive years. In females, the uterus is the most common site. These tumours can be associated with fibroids and tend to mimic them clinically and radiologically, making pre-operative diagnosis very difficult. We report two cases of uterine adenomatoid tumours that were excised laparoscopically. Intraoperatively, there was no clear line of demarcation between the uterus and the tumours and laparoscopic manipulation of the tumours was difficult due to their friable nature. Simple excision with uterine conservation is the treatment of choice, especially in women who desire future fertility, as degeneration, recurrence, malignant transformation or metastasis has not been reported.

Adenomatoid tumours should always be included in the differential diagnosis along with adenomyosis and post-GnRH analogue treatment changes, when difficulty is encountered in identification of operative planes during a routine laparoscopic myomectomy. Apart from explaining the operative difficulties, the identification of these tumours also helps in post-operative counselling of these patients as these tumours unlike fibroids do not recur.