Abstract: Objective：To study the clinical features, diagnosis, treatment and prognosis of patients with atypical polypoid adenomyoma (APA). Methods：This is a retrospective study of 24 cases who suffered from APA admitted in Fuxing Hospital, Capital Medical University from January 2006 to June 2015. Their clinical features, diagnosis, treatment and prognosis were analyzed. The clinical feature of 17 cases (70.8%) were vaginal bleeding, 1 case (4.2%) vaginal discharge, 3 cases (12.5%) primary infertility. Ultrasound had shown occupied lesions within uterine cavity in 3 patients (12.5%). Twenty two patients were performed hysteroscopic surgery. Diagnosis was confirmed by pathological report. Results：Diagnosis of 24 cases were confirmed by pathologic report. The diagnosis of polyp by hysteroscopy and color ultrasound were 61.1% and 68.4% separately. The diagnosis of submucous myoma by hysteroscopy and color ultrasound were 11.5% and 15.8% separately. The differences were no significantly. The operating time was (23.7±8.6) min (5-40 min), the operating bleeding was (6.5±2.9) mL (5-20 mL). Postoperative follow-up consisted 1 to 10 years for 24 cases. Four cases lose follow-up. Three patients were performed hysterectomy after hysteroscopic polypectomy and postoperative follow-up was normal. At 3 months later hysteroscopic second look still shown APA in 1 case who was performed hysteroscopic polypectomy again and intramuscular injection GnRHa, till pathological report was normal levonorgestrel-releasing intrauterine system(LNG-IUS) was inserted into uterine cavity. Up to now 2 years follow-up there was no abnormalities. One case was performed hysterectomy 8 years later because of endometrial intraepithelial neoplasia. Fifteen cases follow-up so far no abnormality. There were 2 infertile patients got pregnancy and term delivery after surgery. Conclusions：As an effective treatment of APA hysteroscopic surgery has many advantages: positioning accuracy, mini-invasive and low recurrence rate. Owing to APA had the possibility of recurrence and malignant change, after surgery continuously and closely follow-up is still important.

Key words: Endometrial neoplasms, Adenomyoma, Polyps, Hysteroscopes；Prognosis