What are the other Names for this Condition? (Also known as/Synonyms)

• APA of Uterus
• Atypical Polypoid Adenomyoma of Uterus
• Uterine Atypical Polypoid Adenomyoma

What is Atypical Polypoid Adenomyoma of Uterine Corpus? (Definition/Background Information)

• Atypical Polypoid Adenomyoma (APA) of Uterine Corpus is a benign polyp-like tumor of the endometrial glands. It is mostly observed in the lower part of the uterus, towards the cervix
• However, some tumors are known to progress to atypical hyperplasia (premalignant condition) and such women carry a higher risk for development of endometrial adenocarcinoma
• The tumor is seen in females of a wide age range. Atypical Polypoid Adenomyoma of Uterine Corpus is classified as a mixed epithelial and mesenchymal tumor of the uterine corpus
• Genetic factors may be involved in the cause of tumor development in some cases. Occasionally, an association of Atypical Polypoid Adenomyoma of Uterine Corpus with Turner syndrome (a genetic disorder) or adenocarcinoma of the endometrium is noted
• The tumors are generally painless and asymptomatic in some cases. Some women may have heavy bleeding during menstruation and irregular periods. Large tumors sizes can cause signs and symptoms due to compression of adjoining organ structures
• The treatment of choice for Atypical Polypoid Adenomyoma of Uterine Corpus is a surgical removal of the entire tumor. In most cases, the prognosis is excellent with appropriate treatment

Who gets Atypical Polypoid Adenomyoma of Uterine Corpus? (Age and Sex Distribution)

• Atypical Polypoid Adenomyoma of Uterine Corpus may affect females of a wide age range
• There is no geographical, racial, or ethnic preference noticed

What are the Risk Factors for Atypical Polypoid Adenomyoma of Uterine Corpus? (Predisposing Factors)

• No specific risk factors are noted for Atypical Polypoid Adenomyoma of Uterine Corpus
• However, very few cases have been associated with Turner syndrome (a genetic chromosomal condition)
• In some individuals, an association of the tumor with endometrial cancer (adenocarcinoma) is observed

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Atypical Polypoid Adenomyoma of Uterine Corpus? (Etiology)

• The exact cause of Atypical Polypoid Adenomyoma of Uterine Corpus development is unknown
• Involvement of MLH-1 gene has been noted in about 40% of the cases
• Research also indicates that tumor may be associated with microsatellite instability (which is related to DNA mismatch repair)
• Research is being performed to understand the causative factors of this rare condition

What are the Signs and Symptoms of Atypical Polypoid Adenomyoma of Uterine Corpus?

The signs and symptoms of Atypical Polypoid Adenomyoma of Uterine Corpus may include the following:

• The tumor involves the endometrial glands and are generally painless
• Most frequent location is the lower part of the uterus (towards the cervical outlet)
• The average size of the tumor is about 2 cm; some tumors can grow up to 6 cm in size
• Atypical polypoid adenomyomas appear like polyps
• Some women may experience abnormal vaginal bleeding
• Some women may not experience any symptoms
• Large tumors may cause a feeling of fullness in the abdomen
• Enlargement of lower abdomen
• Frequent urination due to compression/pressure of the tumor
• Lower back pain

How is Atypical Polypoid Adenomyoma of Uterine Corpus Diagnosed?

The diagnosis of Atypical Polypoid Adenomyoma of Uterine Corpus may involve the following tests and procedures:

• Complete physical examination with thorough evaluation of medical history
• Ultrasound scan of the pelvis: It is a noninvasive procedure that uses high frequency sound waves to produce real-time images
• Abdominal and pelvic CT scan: It is a noninvasive procedure that provides more details of soft tissues, blood vessels, and internal organs
• Pelvic MRI scan: It is a noninvasive medical test that uses a powerful magnetic field to produce images of soft tissues, bones, organs, and all other internal structures of the abdomen and pelvis
• Blood tests that include:
  • Complete blood count (CBC) to detect the cause of anemia
  • Determination of estrogen/progesterone levels in blood
• Hysteroscopy: This procedure involves placing a probe through the cervix to examine the cavity of the uterus. This exam is helpful in detecting submucosal tumors
• Hysterosalpingography: It is usually performed in individuals with infertility. In this procedure, the structure of the uterus and fallopian tubes are studied by using a dye and X-ray images
• Needle biopsy of tumor: A needle biopsy may not be helpful, because one may not be able to visualize the different morphological areas of the tumor. Hence, a needle biopsy as a diagnostic tool has certain limitations, and an open surgical biopsy is preferred
• Open biopsy of tumor: A tissue biopsy is performed and sent to a laboratory for a pathological examination, who examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
• Differential diagnosis, to eliminate other tumor types is considered, before arriving at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Atypical Polypoid Adenomyoma of Uterine Corpus?

The possible complications of Atypical Polypoid Adenomyoma of Uterine Corpus include:

• Stress and anxiety due to fear of cancer of the uterus
• Complications due to the development of endometrial adenocarcinoma, which is a malignant tumor
• Polypoid tumors may undergo mechanical injury, such as torsion or twisting, which can result in excruciating pain
• The polyps may cause cervical prolapse
• Some tumors may grow to large sizes, and even grow out of the uterus affecting adjoining reproductive organs
• There may be complications due to the tumor in pregnant women

How is Atypical Polypoid Adenomyoma of Uterine Corpus Treated?

The treatment of Atypical Polypoid Adenomyoma of Uterine Corpus may depend upon a consideration of the following set of factors:

• Size of the tumor
• Severity of the signs and symptoms
• Location of the adenomyoma
• Age of the individual
• Whether the women is pregnant or not,
• And the women’s desire to have children in future

The following treatment methods may be employed:

• Medical treatment options:
  • Pain medications
  • Dietary and lifestyle modification to address overweight issues
• Surgical treatment options: A simple surgical excision and removal of the entire tumor is normally sufficient treatment, which may be undertaken through the following measures:
  • Myomectomy: Removal of the tumor
  • Hysterectomy: The removal of a part of the uterus or the entire uterus
  • Myolysis: In this procedure, a needle is inserted into the tumor. After the insertion, the tumor is destroyed either by using an electric current, or by a freezing technique
  • Tumor embolization is a possible treatment option. Here the blood supply to the tumor is blocked resulting in its death
  • Radiofrequency ablation: In this technique, the tumors are destroyed using radio waves
• Post-operative care is important: One must maintain minimum activity levels, until the surgical wound heals
• Treatment of any underlying or associated disorder
• Follow-up care with regular screening and check-ups are important

How can Atypical Polypoid Adenomyoma of Uterine Corpus be Prevented?

• Current medical research has not established a way of preventing Atypical Polypoid Adenomyoma of Uterine Corpus
• Regular medical screening at periodic intervals with blood tests, radiological scans, and physical examinations are highly recommended

What is the Prognosis of Atypical Polypoid Adenomyoma of Uterine Corpus? (Outcomes/Resolutions)

• In a majority, the prognosis of Atypical Polypoid Adenomyoma of Uterine Corpus is generally excellent on surgical excision and removal of the tumor. However, the prognosis may also depend upon the severity of the signs and symptoms and other factors
• Some cases are known to progress to atypical hyperplasia, which is a precancerous condition; hence, a surgical removal of the tumor is normally performed
• In some women, an association with adenocarcinoma of endometrium is observed. The risk for such a cancer is about 1 in 10 for women having atypical polypoid adenomyoma (whereas the general risk for such a cancer in women with polyps in the endometrium is less than 1 in 100)

Additional and Relevant Useful Information for Atypical Polypoid Adenomyoma of Uterine Corpus:

Adenomyoma of uterine corpus is a benign tumor that involves the smooth muscles of the endometrium (inner uterus layer composed of epithelial cells) and the endometrial glands. The tumor is mostly found in women less than 50 years old, who frequently have problems related to menstruation.