Pathology

A 42-year-old woman has had menometrorrhagia for the past 2 months. She has no history of prior irregular menstrual bleeding, and she has not yet reached menopause. On physical examination, there are no vaginal or cervical lesions, and the uterus appears normal in size, but there is a right adnexal mass. An abdominal ultrasound scan shows the presence of a 7-cm solid right adnexal mass. Endometrial biopsy shows hyperplastic endometrium, but no cellular atypia. What is the most likely lesion that underlies her menstrual abnormalities?