• Xuemei Qing, Min Xie, Hongying Guo, Bangfang Xie, Hailong Huang, Yong Zhang, and Ying Ma.
• Department of Obstetrics and Gynecology, Qingbaijiang District People's Hospital, Chengdu, Sichuan, China.
• Medicine (Baltimore). 2024 Jul 12; 103 (28): e38885e38885.

RationaleUterine adenomyomas (UAs) are common benign tumors, usually not exceeding 280 g or the weight of the uterus at 12 weeks gestation. Postmenopausal giant UAs of diameter larger than 20 cm are rare, as well as steatosis, but curable by surgical excision. Few cases of postmenopausal giant UAs have been reported.Patient ConcernsHerein, we report a case of a 70-year-old female patient who presented with a giant pelvic tumor of about 20 cm × 18 cm × 20 cm with postmenopausal vaginal bleeding, and whose radiographic manifestations did not exclude the possibility of uterine malignancy.DiagnosesHistopathology confirms an adenomyoma with partial adipose metaplasia.InterventionsWe did an open laparotomy of hysterectomy, bi-adnexectomy, and pelvic adhesion release for the patient.OutcomesPathology revealed adenomyoma with adipose metaplasia. The patient recovered well and was discharged on postoperative day 7 with satisfactory follow-up.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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