Adenomyomatous endometrial polyp is a rare type of endometrial polyp that causes abnormal uterine bleeding and is often confused with submucosal fibroids and requires pathological examination to differentiate them. The diagnosis, treatment and prognosis, and the need for postoperative adjuvant drug therapy are rarely reported at home and abroad, and are discussed in this study. 1. Occurrence of endometrial adenomyomatous polyp Endometrial adenomyomatous polyp is a rare type of endometrial polyp, which is less reported at home and abroad, and abnormal uterine bleeding is its common symptom. Chen Lezhen divided the polyps into 3 types: (1) originating from mature endometrium, i.e. functional polyps, accounting for 20%. (2) Non-functional polyps, which originate from immature endometrium, accounting for 65%. Van Bogaert reported that the incidence of endometrial polyps was 23.8%, and the prevalence was 6.7% in postmenopausal women. The incidence rate of 5.7% was reported in China, and the age of onset was 30-60 years old, with the peak incidence around 60 years old. During the same period, 1672 cases of hysteroscopic endometrial polypectomy and 42 cases of endometrial adenomyotic polyps (2.51%) were performed in our hospital, of which 21.43% were in postmenopausal women. In this study, endometrial adenomyomatous polyps were mostly larger, with the largest diameter ≥3 cm accounting for 47.62%, and the largest polyp was 6 cm long. 2. Diagnosis of endometrial adenomyomatous polyps The diagnosis of endometrial adenomyomatous polyps can be based on clinical manifestations, ultrasonography, hysteroscopy, hysterosalpingography, computed tomography or magnetic resonance imaging, etc. Since they are easily confused with submucosal fibroids, the diagnosis needs to be confirmed by pathology. Since it is easily confused with submucosal fibroids, pathological examination is needed to confirm the diagnosis. Abnormal uterine bleeding is the most common symptom, with an incidence of 88.10% in this group and 77.78% in postmenopausal patients. Mi et al. reported that the sensitivity of vaginal ultrasound diagnosis of endometrial polyps was 71.10% and the specificity was 94.90%.Veeranarapanich et al. reported that the accuracy of hysteroscopy for endometrial polyps was 81.21%, sensitivity 92.59%, specificity 78.98%, positive predictive value 46.29% and negative predictive value 1.21%, suggesting that hysteroscopy has high accuracy, but the positive predictive value is not high, so histopathological confirmation of the diagnosis is needed. However, separate reports on endometrial adenomyomatous polyps have been rarely seen in China and abroad. In this study, the sensitivity of both hysteroscopy and ultrasound in diagnosing endometrial adenomyomatous polyps was not high, but hysteroscopy was superior to ultrasound. And the rate of misdiagnosis as submucosal fibroids was higher in both methods. 3, Atypical polypoid adenomyoma uterus Atypical polypoid adenomyoma is a rare benign tumor of the uterus that has been found to coexist with or develop into endometrial adenocarcinoma [6]. It usually occurs in premenopausal women, and hysteroscopic tumor resection can be considered for patients who require preservation of reproductive function or cannot tolerate hysterectomy, but must be followed up closely after surgery. Ning Yan et al. analyzed five patients with atypical polypoid adenomyoma of the uterus, one of which was combined with endometrioid adenocarcinoma and one with a well-differentiated adenocarcinoma component in local distribution, and all four patients were alive (3 to 60 months) at postoperative follow-up. Therefore, atypical polypoid adenomyoma needs to be differentiated from highly differentiated endometrioid adenocarcinoma, which can coexist. Endometrial atypical polypoid adenomyoma, with low malignant potential and potential recurrence, can develop into endometrioid adenocarcinoma, so long-term follow-up is necessary. In this study, only one of the five patients with atypical polypoid adenomyoma was treated with highly effective progesterone after surgery, and all of them were followed up for 2 to 7 years with good prognosis. 4.Treatment of endometrial adenomyotic polyps In view of the special histopathology of endometrial adenomyotic polyps, drug treatment and curettage cannot obtain satisfactory results. For adenomyomatous polyps prolapsing from the uterine orifice, clamping can also be considered for removal, but it is difficult to ensure complete removal of the polyp root. For patients with atypical polypoid adenomyoma who are young or have fertility requirements, the uterus can be preserved with close follow-up and supplemented with highly effective progesterone therapy if necessary, as long as the polyps are completely removed. For those who do not have reproductive requirements or are too old to be followed closely, hysterectomy may be considered.