Atypical Polypoid Adenyome

Saeko: There is a case of a female, 54 kg, with APA (atypical polypoid adenomyoma). The polyps were removed once, but a follow-up biopsy showed that the APA had recurred. She doesn’t have any other health issues.

Dr. Kaye: APA is usually caused by an imbalance of female hormones. High estrogen exposure leads to increased production of polypoid cells.

Polypoid cells (such as those in APAs) have elevated levels of oxygen free radicals, which are associated with high metabolic activity and can increase tumorigenicity. Hence, BN can help patients with this problem. You may give the patient 4 sachets daily and consider a “bombing” dose once a week. This should be treated as a premalignant condition.

Saeko: How long would you suggest she take BN for her case? How long does it typically take to improve her condition?

Dr. Kaye: It depends on how long she has had the condition. BN can help control the damage caused by the polypoid cells, but the underlying hormonal issue remains. Once she reaches menopause, there will already be a shift in the estrogen and progesterone balance. I would recommend continuing BN until she reaches menopause. However, the bombing dose may be done for 3–4 months.