An unusual case of focal adenomyotic cyst diagnosed & managed hysteroscopically

Focal adenomyotic cyst is defined as a cystic structure lined by endometrial tissue and surrounded by the myometrium. It is a rare and benign pathology. It is seen in adolescents and young women of reproductive age group. The presenting complaints are non specific. Most commonly, women present with dysmenorrhea, chronic pelvic pain or abnormal uterine bleeding. Now a day’s its incidence is rising, one because of increasing age of conception and second because of availability of high quality imaging modalities and minimally invasive techniques such as hysteroscopy. With this background, author here report a case of 29 years old woman who presented with primary infertility since 7 years. Her laboratory investigations were normal. Ultrasound pelvis was normal. Diagnostic hysteroscopy was done, which showed mild adhesions in the uterine cavity, for which fundal and lateral wall metroplasty was done. After adhesiolysis, a brown coloured cystic lesion was visualised on posterior wall of uterus, of size 2 × 2 cm, which was excised with 5 Fr scissors. On excision, haemorrhagic fluid was drained, thus confirming the diagnosis. On conclusion, although adenomyotic cyst is a rare form of adenomyosis but now since the incidence is on rising trend, thus gynaecologists need to be more vigilant for its diagnosis and management. Through this case, authors would like to highlight the diagnostic and therapeutic role of hysteroscopy for focal adenomyotic cyst.