Uterine adenomyoma with exophytic subserosal growth: case report of rare manifestation with image diagnosis and laparoscopic-assisted excision.

Uterine adenomyoma is a nodular aggregated form of adenomyosis composed of heterotopic endometrial or endometrium-like structures in the myometrium, with adjacent myometrial hyperplasia. Although adenomyoma is not extremely rare, reports of adenomyoma showing exophytic subserosal growth are limited. A 32-year-old nulligravida woman had sudden onset of lower abdominal pain. In addition to a left endometriotic cyst, a heterogeneous mass lesion showing mural and exophytic subserosal growth was noted in the posterior wall of the uterus. In a two-port laparoscopic-assisted procedure, the subserosal nodule was excised using ultrasonic coagulating shears, followed by excision of the mural lesion using a round loop electrode and a high-frequency electrosurgical unit. The histopathologic diagnosis was adenomyoma.