Precarious preoperative diagnostics and hints for the laparoscopic excision of uterine adenomatoid tumors: two exemplary cases and literature review

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Precarious preoperative diagnostics and hints for the laparoscopic excision of uterine adenomatoid tumors: two exemplary cases and literature review Ibrahim Alkatout, M.D., Bernd Bojahr, M.D., Linda Dittmann, M.D., Viktoria Warneke, M.D., Liselotte Mettler, M.D., Walter Jonat, M.D., Thoralf Schollmeyer, M.D. Fertility and Sterility Volume 95, Issue 3, Pages 1119.e5-1119.e8 (March 2011) DOI: 10.1016/j.fertnstert.2010.10.017 Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Preoperative transvaginal ultrasound scan showing the typical misleading sonographic picture of a fibroid (case 1). Fertility and Sterility 2011 95, 1119.e5-1119.e8DOI: (10.1016/j.fertnstert.2010.10.017) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

Figure 2 (A) Intraoperative view of the adenomatoid tumor connected to the surrounding myometrium (case 1). (B) Reconstruction of the uterine wall after excision of the tumor (case 1). (C) Removal of the adenomatoid tumor by morcellation (case 2). Fertility and Sterility 2011 95, 1119.e5-1119.e8DOI: (10.1016/j.fertnstert.2010.10.017) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

Figure 3 (A) Low magnification (×25) of the uterine adenomatoid tumor, showing the typical tubular–glandular growth pattern and surrounding small muscle cells. Hematoxylin and eosin. (B) Lining cells in typical cuboidal growth pattern with non-suspicious nuclei at high magnification (×400). Hematoxylin and eosin. (C) Strongly positive immunohistochemical calretinin staining of the tumor tissue (×25). (D) Positive calretinin-stained tumor cells at high magnification (×400). (E, F) Immunohistochemical CD34 staining showing no positive staining of the tumor cells but the surrounding lymphovascular endothelial cells in low and high magnification (×25 and ×400, respectively). (G) Immunohistochemical Ki-67 staining (×10) showing no enhanced mitotic activity of the tumor tissue. Fertility and Sterility 2011 95, 1119.e5-1119.e8DOI: (10.1016/j.fertnstert.2010.10.017) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions