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In our study, TLH can be performed successfully in patients with a history of abdominal surgery.

Cystic adenomyosis, a cystic lesion in the myometrium, is a rare disease that is characterized by intense dysmenorrhea. Here we report a case of a woman diagnosed with adnexa chocolate cyst that was found to be cystic adenomyosis during laparoscopic surgery. The case is of a 37-year-old woman, gravida 0 and para 0. When she was 32 years old, she visited a nearby hospital for dysmenorrhea. She was diagnosed with adnexa chocolate cyst in both sides and was followed up with oral low dose of estrogen-progestin (LEP). Five years later, she was suggested to undergo surgery because of the increasing size of the cysts. During the laparoscopic surgery, we found that the cystic lesion was not typical, and the connection with the uterus was clear. The pathological findings were consistent with the diagnosis of cystic adenomyoma. We suggest that when cystic lesions are identified with severe dysmenorrhea, the connection with the uterus and the possibility of cystic adenomyoma should be considered.

Endometrial cancer should be considered in women with inappropriate vaginal bleeding, menstrual abnormalities, or discolored vaginal discharge. We experienced a case without the above risk factors, in which a preliminary diagnosis was made with endometrial cytology. The case was of a 66-year-old woman, gravida 2 and para 2. She had no inappropriate vaginal bleeding, and transvaginal ultrasound examination showed a thin endometrium. However, endometrial cytology was positive. We performed laparoscopic hysterectomy and bilateral salpingo-oophorectomy based on a clinical diagnosis of Stage IA uterine corpus cancer. The postoperative pathologic diagnosis was stage IB Grade 2 endometrial adenocarcinoma. Therefore, the possibility of uterine corpus cancer must still be considered in cases without risk factors. And cytologic sampling should be considered an effective method for diagnosis of uterine corpus cancer because of its high sensitivity and specificity.

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