Giant exophytic cystic adenomyosis with a levonorgestrel containing intrauterine device out of the uterine cavity after uterine myomectomy: A case report

Figure 1 Imaging examinations. A: B-mode ultrasound showed an anterior and normal uterus size and a cystic echogenic mass that measured 9.5 cm × 7.4 cm × 7.4 cm located at the posterior uterine isthmus. The white arrow indicates an intrauterine device contained within this cystic mass; B: On the T1-weighted image, the uterine isthmus muscle was discontinuous, and the cervical canal lost its normal shape. A communication was observed between the posterior isthmus of the uterus and the endometrial cavity and cervical canal.

Figure 2 Laparoscopic excision of the mass was performed for the patient. A and B: Appearance of the cystic adenomyosis at different directions; C: Chocolate-colored liquid content overflowed from the incision; D: The incision was enlarged and a levonorgestrel-containing intrauterine device was exposed after sucking the cystic fluid; E: The cervical canal was enlarged by the expanding-uterus stick to prevent stenosis; F: Continuously suturing the entire uterine wall twice to reconstruct the uterine wall.