Cystic Adenomyoma simulates uterine malformation: A diagnostic dilemma: Case report of two unusual cases
A 22-year-old female P1+1 presented with the complaint of severe dysmenorrhea, menorrhagia and secondary infertility for two years. At consultation in other hospital, diagnostic laparoscopy was performed and she was diagnosed as having broad ligament fibroid and referred to our laparoscopy center. Transvaginal ultrasonography was suggestive of cystic mass in uterus with mixed echogenicity. On performing the laparoscopy, endometriotic implants were found on bilateral ovaries and uterosacral ligaments which were fulgurated with the bipolar cautery. Uterine veins were tortuous and forming the plexus in the broad ligament. A cystic swelling was noted on the anterior surface on right side of uterus below the round ligament. Diluted vasopressin (Pitressin, 5 units in 100 ml of normal saline) was injected into the cystic swelling. A transverse incision was given on the anterior surface of swelling with the harmonic scalpel. When the incision reached the cystic cavity, thick chocolate material was drained [] and the defect was closed with vicryl 2-0, meticulously []. Good approximation was achieved. There were no intraoperative or postoperative complications. The patient was discharged next day after surgery.