Benign / nonneoplastic lesions
Atypical polypoid adenomyoma

Author: Branko Perunovic, M.D. (see Authors page)

Revised: 18 April 2017, last major update May 2007

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: Atypical polypoid adenomyoma cervix

Cite this page: Atypical polypoid adenomyoma. PathologyOutlines.com website. http://pathologyoutlines.com/topic/cervixapa.html. Accessed April 24th, 2017.
Definition / General
  • Also called atypical polypoid adenomyofibroma, APA
  • Occurs in endometrium, lower uterine segment and endocervix
  • Uncommon (< 150 cases reported), associated with Turner syndrome
  • Mean age 40 years, range 21 - 73 years
  • Symptoms of dysfunctional uterine bleeding
  • May persist or recur, but does not metastasize; may have increased risk for later carcinoma; may be contiguous with adenocarcinoma
Case Reports
  • Conservative polypectomy and curettage or simple hysterectomy in peri/postmenopausal women, but with follow up
Gross Description
  • Resembles endometrial polyp
  • Single, well-circumscribed, polypoid mass up to 2 cm
  • Usually confined to endometrium with pushing margin
  • Remaining endometrium is often unremarkable
Gross Images

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Polypoid mass (arrow)

Micro Description
  • Biphasic with hyperplastic and atypical endometrial glands (complex architecture, often severe cytologic atypia), separated by fascicles of bland smooth muscle and fibrous storm
  • Squamous metaplasia present (90%), often extensive or with central necrosis
  • Minimal mitotic activity (<3 mitotic figures per 10 HPF)
  • No desmoplasia
  • Low malignant potential - with features resembling well differentiated adenocarcinoma
Micro Images

Images hosted Pathout server:

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Atypical complex glandular hyperplasia, smooth muscle stroma and morules

Cytology Description
Positive Stains
Differential Diagnosis
  • Adenocarcinoma with muscular invasion: older women, grossly invasive, large with hemorrhage and necrosis, has desmoplasia
  • MMMT: older women, stroma also malignant, diffuse atypia, increased mitotic activity
Additional References