Adenomyosis 10 cm can be removed without surgery if the patient is menopausal or near menopause and has no clinical symptoms, because after menopause estrogen and progesterone decline and the lesion will not grow any more and may even shrink gradually. However, in most cases, women who are not menopausal or have significant clinical symptoms, a lesion of 10 cm needs to be surgically removed. Adenomyosis 10 cm is a larger lesion and is often associated with various symptoms such as excessive menstrual flow, dripping menstruation, and painful menstruation. If clinical symptoms are present and there is no menopause, surgical removal is required. Although the probability of adenomyosis becoming malignant is low, it is not completely impossible. For a 10 cm lesion, total hysterectomy is usually the choice. If a woman is adamant about preserving her fertility, the lesion can also be removed. After hysterectomy, pathological tests should be sent to clarify the diagnosis, and if it suggests uterine sarcoma or focal lesions that are already cancerous, additional treatment should be given according to malignancy, with bilateral adnexal resection, pelvic lymph node dissection, or even parietal aortic lymph node dissection. Postoperatively, the decision of whether to supplement radiotherapy is based on the presence of high-risk factors, and if lymph node metastasis is found after surgery, supplemental radiotherapy is given.