Total laparoscopic hysterectomy is increasingly being performed for uterine adenomyosis following widespread use of laparoscopic surgery in clinical practice. We report a case of postoperative endometrial cancer following total laparoscopic hysterectomy performed for uterine adenomyosis.

　A 45-year-old woman underwent total laparoscopic hysterectomy for dysmenorrhea. No abnormal bleeding or endometrial thickening was observed preoperatively; however, she was diagnosed with endometrioid adenocarcinoma based on postoperative histopathological examination.

　Studies in the available literature have reported that the rate of malignant transformation of uterine adenomyosis is the same as that observed in cases of ovarian chocolate cysts. Early detection of malignant transformation of uterine adenomyosis is challenging. Notably, laparoscopic surgery may result in dissemination of malignant cells; therefore, accurate preoperative diagnosis and careful management are important in these patients considering potential malignant transformation.