{"paper_id":"5492803d-054d-475c-b8df-6f93449a784a","body_text":"Abstract\nBackground\nJuvenile cystic adenomyoma (JCA) is an uncommon form of adenomyosis. No consensus exists regarding its optimal treatment. Despite the potential long-term complications, lesion resection is the radical therapy for JCA. Given the dual goals of symptom control and fertility preservation in such young adolescents, treatment selection is often challenging, highlighting the need for alternative therapeutic choices.\nCase presentation and literature review\nWe report the case of a 14-year-old nulliparous female with severe dysmenorrhoea refractory to medical treatment who was successfully managed with a levonorgestrel-releasing intrauterine system (LNG-IUS) fixed to a GyneFix® frameless intrauterine device (IUD) to prevent re-displacement. A review of 14 published articles (covering 19 reported cases) on JCA revealed a lack of consensus on standardized treatment and highlighted the frequent use of more invasive surgical procedures, such as laparoscopy or laparotomy, for lesion resection. These surgical approaches, while often effective, are associated with potential risks, including uterine wall injury and potential future fertility-related complications. In contrast, the combined IUD approach achieved long-term symptom relief for > 16 months.\nConclusion\nFor adolescents with JCA, the combined LNG-IUS and GyneFix® technique represents a promising, minimally invasive, and fertility-preserving treatment strategy, particularly for patients who previously achieved satisfactory symptom control with Mirena® therapy but experienced device expulsion or displacement. By effectively reducing the risk of device expulsion, this combined approach offers a conservative alternative to more invasive surgical intervention while aiming to preserve fertility.\nSimilar content being viewed by others\nAbbreviations\n- JCA:\n-\nJuvenile cystic adenomyoma\n- LNG-IUS:\n-\nLevonorgestrel-releasing intrauterine system\n- IUD:\n-\nIntrauterine device\n- CPP:\n-\nChronic pelvic pain\n- VAS:\n-\nVisual analog scale\n- CA-125:\n-\nCancer antigen 125\n- MRI:\n-\nMagnetic resonance imaging\n- TRUS:\n-\nTransrectal ultrasonography\n- OCs:\n-\nOral contraceptives\n- GnRHa:\n-\nGonadotropin-releasing hormone agonist\nAcknowledgements\nNot applicable.\nFunding\nThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nEthics approval and consent to participate\nAccording to the regulations of our institution, ethical approval was not required for this single case report. The report was conducted in accordance with the Declaration of Helsinki.\nConsent for publication\nWritten informed consent was obtained from the patient and her legal guardian for the publication of this case report and any accompanying medical information.\nCompeting interests\nThe authors declare no competing interests.\nAdditional information\nPublisher’s note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nOpen Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.\nAbout this article\nCite this article\nHan, C., Nie, L., Zhang, P. et al. Treatment of juvenile cystic adenomyoma through combined insertion of LNG-IUS and GyneFix®: a case report and literature review. BMC Women's Health (2026). https://doi.org/10.1186/s12905-026-05051-4\nReceived:\nAccepted:\nPublished:\nDOI: https://doi.org/10.1186/s12905-026-05051-4","source_license":"CC0","license_restricted":false}