Case Of Adenomyosis Research Articles

A Case of Adenomyosis Showing Size Reduction in a Follicular Lymphoma Patient Receiving Chemotherapy With R-Bendamustine.

We describe a case of adenomyosis that reduced in size in a patient with lymphoma on receiving chemotherapy. A 48-year-old woman with worsening left flank pain was diagnosed with follicular lymphoma. [ 18 F]FDG PET/CT revealed multiple hypermetabolic lymph nodes in the bilateral cervical, axillary, mediastinal, mesenteric, retroperitoneal, iliac, and inguinal regions. In addition, adenomyosis with mild hypermetabolism was demonstrated on [ 18 F]FDG PET/CT. The size and metabolism of adenomyosis decreased after chemotherapy with R-bendamustine; in addition, along with decrease in estradiol levels, the patient experienced amenorrhea and hot flushes. The patient was diagnosed with chemotherapy-induced early menopause.

Successful Healing Treatment of Adenomyosis Using Yoga Prana Vidya (YPV) System

Introduction: A 37 years old female was diagnosed with Adenomyosis and heavy bleeding during menstrual cycle. She had a history of irregular menstrual cycle and lower abdominal pain. The prescribed medicines did not help her much. So she did not take medication. She decided to take help from Yoga Prana Vidya (YPV) Trained Healer. This paper presents the case of Adenomyosis treated successfully with Yoga Prana Vidya Healing protocol. Methods: This is the case study method with detailed analysis of medical records of patient’s health condition pre and post YPV healing treatment applied as alternative medicine. This is the case of a 37 years old female diagnosed with Adenomyosis in December 2020. Initial symptom was bleeding got started after one week of completion of menstrual cycle. A Gynaecologist advised to get the Ultrasound done which diagnosed Adenomyosis. The doctor prescribed Hysteroscopic D&C followed by Mirena insertion. She used to have painful menstrual cycle with heavy flow every month. Results: Analysis of the patient’s health condition and medical case documents pre and post treatment shows that she got cured with Yoga Prana Vidya (YPV) healing method for Adenomyosis. Conclusion: This case study documents the evidence on the effective use of YPV in treating Adenomyosis and heavy bleeding during menstrual cycle. There is ample scope to conduct further research on the application of YPV as alternatively effective and low cost medicine for various medical conditions.

A case of adenomyosis with leiomyoma that was effectively treated with relugolix and kamishoyosan add-on therapy

BackgroundRecently, relugolix, an oral gonadotropin-releasing hormone receptor antagonist, has been considered an effective therapy for leiomyoma based on a phase 3 study in Japanese women. Leiomyoma combined with severe adenomyosis occasionally occurs in perimenopausal women; however, little information on the effectiveness of relugolix against severe adenomyosis exists.Case presentationA 49-year-old woman was referred to our hospital with acute lower abdominal pain and abnormal uterine bleeding. Magnetic resonance imaging revealed multiple leiomyomas with diffuse adenomyosis. Left hydrosalpinx was also observed. The patient refused surgical treatment and preferred oral relugolix. Since she experienced a hot flush and headache induced by relugolix, a traditional Japanese Kampo, kamishoyosan, was added to improve the side effects of relugolix. The patient was asymptomatic at the time of this report and experienced a significant shrinkage in uterine volume. Ultimately, she avoided hysterectomy as desired.ConclusionsTo our knowledge, this is the first report of co-occurring adenomyosis and leiomyoma, which was effectively treated with relugolix. Although the management of adverse side effects, including hot flush and headache by relugolix, has recently attracted attention and controversy, relugolix add-on therapy with kamishoyosan may help treat menopausal symptoms.

Systemic thromboembolism including multiple cerebral infarctions with middle cerebral artery occlusion caused by the progression of adenomyosis with benign gynecological tumor: a case report

BackgroundAdenomyosis, a benign gynecological disease, causes cerebral infarction. Similar to Trousseau’s syndrome, it elevates cancer antigen 125 (CA125) and D-dimer levels; causes hypercoagulability; and results in cerebral infarction. However, no case of adenomyosis causing major cerebral artery occlusion and requiring endovascular thrombectomy has yet been reported. We report on a woman with middle cerebral artery occlusion caused by adenomyosis progression with a benign gynecological tumor and recurrent cerebral infarction. She was successfully treated by endovascular thrombectomy and hysterectomy.Case presentationA 48-year-old woman with heavy uterine bleeding was transported by ambulance to our hospital. Upon arrival, she presented with impaired consciousness. Laboratory test results revealed decreased hemoglobin (8.2 g/dL) and elevated D-dimer (79.3 µg/mL) levels. Radiological imaging revealed adenomyosis, a left ovarian tumor, multiple uterine myomas, and old and new bilateral renal infarctions. She experienced repeated episodes of excessive menstruation caused by adenomyosis and was scheduled for hysterectomy in 2 months at another hospital. After hospital admission, uterine bleeding stopped. However, 5 days after initial bleeding, she had another episode of heavy uterine bleeding and developed left hemiparesis and dysarthria 20 min later. Brain magnetic resonance imaging revealed bilateral multiple cerebral infarctions indicating right middle cerebral artery occlusion. Thus, endovascular thrombectomy was performed, and anticoagulant therapy was administered. Laboratory test results after thrombectomy revealed elevated CA125 (3536 U/mL) and CA19-9 (892 U/mL) levels. She was at a risk of recurrent heavy uterine bleeding leading to repeated cerebral infarction because of anticoagulant treatment. Therefore, we performed hysterectomy and ovariectomy 11 days after initial bleeding. Histopathological assessment revealed no malignancy. Although she developed asymptomatic pulmonary thromboembolism 14 days after initial bleeding, D-dimer and tumor marker levels returned to normal soon after gynecological surgery. At 15 months post-surgery, she had not experienced further ischemic events.ConclusionsAdenomyosis with benign gynecological tumors may be associated with elevated D-dimer and tumor marker levels; excessive menstruation; and anemia. It may cause systemic thromboembolism, including cerebral infarction. To our knowledge, no other study has reported that adenomyosis causes major cerebral artery occlusion requiring endovascular thrombectomy. Hysterectomy may be an effective radical treatment of this condition.

A Case of Severe Adenomyosis in a Young Adolescent

Adenomyosis refers to a disorder in which endometrial glands are present within the uterine muscle which can be either diffuse or localized that may cause heavy menstrual bleeding, dysmenorrhea, and infertility. The disease usually affects multiparous women. Around 70-80% of the cases are reported in women of age between 40 and 50 years. Very few cases of adenomyosis in young adolescent are reported, and the diagnosis in such case becomes notoriously difficult, but still can be highly suspected with the help of ultrasound (USS) and Magnetic Resonance Imaging (MRI). Here, we present a case of 15-year old girl attending the emergency care with acute abdominal pain. The patient underwent diagnostic laparoscopy which revealed bleeding in the peritoneal cavity and a big hypertrophied uterus. Erosion and active bleeding was observed from the surface of the uterus; the case was advanced to laparotomy. The uterus was uniformly enlarged and boggy that was completely eroded and bled actively. Multiple biopsies were taken from different parts of uterine lesion and sent for frozen section histopathology examination. The blood was sucked from the peritoneal cavity, followed by placement of multiple hemostatic stitches. The results revealed severe adenomyosis. Only very few cases of adenomyosis in adolescents are reported to date and since fertility preservation is considered as an important goal, the traditional treatment of endometriosis may not be applicable to treat adenomyosis in case of young adolescent for fear of jeopardizing the reproductive life. Preserving the fertility in the adolescent and young adult patients poses a major challenge keeping in mind the adequate treatment required without affecting the general health of the patient.

Adenomyosis in a Perimenopausal Woman Treated by Potentized Poison Hemlock—A Case Report

AbstractAdenomyosis is a common pathological condition of the uterus where its diagnosis and treatment remain still a challenge to the treating physicians. Even though termed as benign, its clinical presentation of heavy, painful menstrual bleeding, infertility and hindrance to a women's quality of life makes it significant cause for treatment. The adenomyosis condition with significant symptoms is dealt with surgically in the conventional system of medicine by way of hysterectomy, uterine artery embolisation or endometrial ablation. These surgical interventions can be prevented with homoeopathic system of medicine. A case of adenomyosis in a 41-year-old female who presented with continuous heavy bleeding and severe pelvic pain was successfully treated with homoeopathy medicine, Conium maculatum, which is commonly called as poison hemlock. The medicine prescribed on totality alleviated not only symptoms of the patient but also resolved adenomyosis completely.

Hysteroscopic Management of Cystic Adenomyosis

Video Objective To demonstrate a case of cystic adenomyosis treated by hysteroscopic intervention and the course of the lesion thereafter. Setting The patient is a 42 years old, G3 P1 woman complaining of heavy menstrual bleeding of 6 months duration with concomitant severe dysmenorrhea. Ultrasound examination revealed a 32 × 30 mm cystic mass in the anterior uterine wall at the junctional zone. Interventions Following hysteroscopic resection with a wire loop resectoscope and rollerball coagulation of the inner surface of the adenomyotic cyst, there was complete disappearance of the anterior myometrial defect and resolution of symptoms 4 months after the surgery. Conclusion Symptomatic cystic adenomyosis on the junctional zone can be managed by hysteroscopic resection. Following creation of an opening on the cyst wall, internal surfaces may be treated with rollerball coagulation. Healing appears complete with no residual dead space on the junctional zone.

Resection of Cystic Adenomyosis

Video Objective To describe a case of cystic adenomyosis and demonstrate the resection of adenomyotic cysts. Setting A 21 year-old nulligravid patient presents for worsening chronic pelvic pain for 3-4 years which is only partially responsive to oral contraceptives. Interventions Ultrasound and MRI images confirmed the diagnosis of cystic adenomyosis, and the patient underwent robotic-assisted laparoscopic resection and removal of cystic adenomyosis. Conclusion Cystic adenomyosis is a rare disorder that requires excision for complete resolution of symptoms. It is necessary to have a high index of suspicion in young patients with dysmenorrhea that does not resolve with hormonal therapy. It is also important for gynecologists to review ultrasound and MRI images themselves and in conjunction with radiologists experienced in pelvic imaging to reduce misdiagnosis.

敗血症性DICに陥った子宮腺筋症の1例(A case of uterine adenomyosis complicated by septic disseminated intravascular coagulation)

要旨子宮腺筋症はしばしば経験するが，これまでに腺筋症内に感染を来し敗血症に陥ったという報告はほとんどない。今回，敗血症性DIC（disseminated intravascular coagulation）に陥った子宮腺筋症の症例を経験した。内科的治療に抵抗性であったが，子宮を摘出することで全身状態はすみやかに改善した。症例は50歳の女性。以前から月経周期不整であった。前日から発熱と下腹部痛を訴え，来院時に強い反跳痛と筋性防御を認めた。骨盤部MRI検査で子宮は12cmに腫大していたが，明らかな感染の所見はなかった。子宮腺筋症に感染を併発した敗血症を疑い，抗菌薬治療を開始した。入院3日目にはSOFAスコアは12点に，急性期DICスコアは6点に上昇した。内科的治療では改善が見込めないと判断し，同日に腹式子宮全摘術を施行した。摘出した子宮の割面から膿汁の流出を認め，腺筋症内に感染を合併していたことが判明した。術後すみやかに循環動態が回復し，炎症反応も低下した。子宮腺筋症に感染を合併した場合，確定診断を得るのは難しい。自験例のように敗血症性DICに陥ることがあり，内科的治療が奏効しない場合は手術を考慮する必要がある。

An unusual case of adenomyosis in a prolapsed fibroid – a case report

An unusual case of adenomyosis in a prolapsed fibroid – a case report

Diagnostic Hysteroscopy and Adenomyosis: The Case of a Uterine Cornual Cavern. A Video Article

Introduction The aim of this study is to show a rare case of adenomyosis presented as a “cavern” which completely involves a uterine cornu. Case description A 39-year-old nulliparous patient, with five previous laparoscopic myomectomies during which multiple myomas and adenomyomas have been removed, presented at the Arbor Vitae Centre for Endoscopic Gynaecology in Rome because of an abnormal uterine bleeding. A 6 cm myoma with multiple endometrial glands inside, located on the left uterine cornu, was enucleated during the last procedure. The ultrasound scan showed a 1 cm endometrial polyp and suspected adenomyosis reaching the serosa on the left uterine cornu. Free-anaesthesia diagnostic hysteroscopy was performed with carbon dioxide as distension medium and using a 30-degree fore-oblique rigid telescope with a diameter of 2.9 mm, covered with a single-flow examination sheath. An electronic hysteroflator was set at a flow rate of 30 mL/min and a maximum intrauterine pressure of 75 mm Hg. Multiple adenomyosis caverns that deepen into the myometrium were found on the left uterine cornu. Conclusions Previous multiple myomectomy may seriously alter the internal uterine anatomy, especially in presence of adenomyosis. In case of presence of numerous recesses in the uterine cavity, a suspicion of adenomyosis should be considered.

Adenomiose uterina em gata associada à piometra

Adenomyosis, a non-neoplastic myometrial proliferation, is a rare pathologic condition in domestic animals, of unknown etiology. There is a lack of information about the clinical and pathological features of this disease in cats, therefore just a few reports in that species. The study describes a case of adenomyosis in a feline female. A cat, six years old, undefined breed, not spayed, had abdominal swelling history and vaginal discharge. Clinically, upon abdominal palpation, a diffuse increase suggesting a uterine change was found. The vulva had sanguine-purulent exudates. The choice was for the neutering surgical. Uterine macroscopy revealed cystic endometrial hyperplasia/pyometra in uterine horns, and the presence of a diffuse mass on uterine corpus. Fragments of the mass were sent for histopathological analysis, which revealed adenomyosis of the uterine corpus. The patient exhibited adequate post-operative recovery. The adenomyosis should be considered as a differential diagnosis of uterine neoformation in domestic cats.

SF1 immunohistochemistry is useful in differentiating uterine tumours resembling sex cord-stromal tumours from potential histological mimics

The aim of this study was to perform an immunohistochemical comparison of uterine tumour resembling ovarian sex cord-stromal tumour (UTROSCT) and other uterine lesions with sex cord-like (SCL) differentiation. Six UTROSCTs and 10 potential histological mimics with focal SCL elements were examined, the latter comprising three endometrial stromal nodules, three low-grade endometrial stromal sarcomas, three Müllerian adenosarcomas, and one case of adenomyosis. All cases were stained immunohistochemically for SF1, FOXL2, calretinin and inhibin, and for the less specific markers smooth muscle actin, desmin, CD10, CD56, CD99, cytokeratin, oestrogen receptor and progesterone receptor. Three, four, six and three UTROSCT expressed SF1, FOXL2, calretinin and inhibin, respectively. However, calretinin staining was focal (≤50% cells positive) in five of the cases. Three potential histological mimics demonstrated calretinin, FOXL2 and/or inhibin staining but none was SF1 positive. Most cases in both groups expressed the less specific immunomarkers. SF1 and FOXL2 immunoreactivity in UTROSCT further supports the concept that these tumours demonstrate genuine sex cord-stromal differentiation. While calretinin was the most sensitive UTROSCT marker, staining was usually focal and expression was also seen in two of 10 potential histological mimics. SF1 staining was 100% specific for UTROSCT in this series but this finding should be confirmed in larger studies.

Adenomyosis of the Extrapelvic Portion of the Round Ligament

Abstract Background: Adenomyosis is a disease of the uterus characterized by invasion of endometrial cells within the myometrium. Adenomyosis is typically confined to the uterus, with no distant localizations. This article reports on a case of adenomyosis of the distal extrapelvic portion of the round ligament. Case: The patient, a 49-year-old woman, had previously undergone surgery for pelvic endometriosis. This prior surgery included removal of uterus, fallopian tubes, and a portion of the sigmorectal intestine. She then presented with a nodule on the right side of her pubis. The nodule was close to the upper part of her right labia majora. She was experiencing cyclic pain, nodule enlargement, and edema on the right side of her pubis. The entire round ligament, from the internal inguinal canal to its distal end above the pubis, was removed. Histology testing revealed that the distal nodule was a myomalike neoformation containing endometrial tissue; this was definable as adenomyosis. Results: After the s...

Rare Case of Leiomyoma and Adenomyosis in Mayer-Rokitansky-Kuster-Hauser Syndrome.

We report a case of adenomyosis which developed from a hypoplastic uterus and leiomyoma in a patient with MRKH syndrome. A 45-year-old Malay female with primary amenorrhoea and primary infertility presented with abdominal mass and abdominal pain. She is phenotypically female, has well developed secondary sexual characteristics, and has normal female external genitalia with shallow vagina dimple. Transabdominal ultrasonography showed a homogenous adnexal mass of 10 × 8 cm, uterus sized 5 × 4 cm, and normal kidneys. A complex mass of right adnexa was demonstrated by CT scan. Exploratory laparotomy showed torsion of right adnexal mass and rudimentary uterus with fibroid but no endometrial tissue and blind end with absent cervix. The normal right ovary and tube were not visualized. The left fallopian tube and ovary were normal. It is also complicated by vaginal agenesis. Removal of right adnexal mass and rudimentary uterus was done with preservation of left ovary. The histologic diagnosis was uterine adenomyosis and leiomyoma arising from the right adnexa, possibly from the broad ligament.

Endometriosis: Ancient or modern disease?

Endometriosis: Ancient or modern disease?

A Case of Adenomyosis of the Uterus

Uterine adenomyosis is considered benign and even though not a life-threatening condition, the frequent pain and heavy bleeding associated with it can have a negative impact on a womanʼs quality of life. This is a condition seen with higher frequency in women with a history of surgical uterine procedures (e.g., Caesarean section, dilatation and curettage). The only definitive cure for adenomyosis is a hysterectomy. This is often the treatment of choice for women with significant symptoms. This surgical intervention can be avoided through homeopathic treatment. A case of uterine adenomyosis in a twenty-seven-year-old female who presented with continuous heavy bleeding showed the efficacy of homeopathic medicines in giving not only symptomatic relief to the patient but also helping in the complete cure of the adenomyosis of the uterus.

Adenomyosis in a Rudimentary Horn of a Mayer-Rokitansky-Küster-Hauser Syndrome

ABSTRACT The prevalence of congenital uterine malformations is about 0.5%. In Mayer-Rokitansky-Küster-Hauser syndrome (MRKH), patients usually present with primary amenorrhea. Here, we report a case of adenomyosis in a rudimentary horn in a 37-yearold woman with MRKH syndrome who had cyclical abdominal pain with increasing frequencies since her 24th year. This case is an evidence for adenomyotic lesions in the myometrium of Müllerian remnant with no functioning endometrium. How to cite this article Meera AD, Rani GU, Syamala O, Rukshana HN. Adenomyosis in a Rudimentary Horn of a Mayer-Rokitansky-Küster-Hauser Syndrome. J South Asian Feder Menopause Soc 2014;2(2):102-104.

A Case of Adenomyosis with a High Titer of IgG Autoantibody to Calreticulin.

Background. High prevalence of autoantibodies to the calcium-binding, endoplasmic reticulum chaperone protein calreticulin has been reported in various autoimmune and parasitic diseases. It has been reported that adenomyosis is associated with the presence of autoantibodies, in particular to phospholipids; however, it is not known whether it is associated with autoimmunity to calreticulin. Results. A 35-year-old gravida 4 para 4 woman presented with a history of many years of intractable menorrhagia. Histopathological examination of a subsequent hysterectomy specimen revealed a bulky uterus, a poorly developed secretory endometrium with decidualization of the stroma and chronic endometritis, as well as the presence of adenomyosis uteri. IgG autoantibodies to calreticulin were measured in the plasma of this and 234 other patients. Nine (3.8%) patients tested positive. The titer of anticalreticulin IgG autoantibody in the sole case with adenomyosis was approximately 8 times the average of other positive-testing samples. Conclusions. The etiology of adenomyosis is unclear. The presence of a high titer, blocking anticalreticulin autoantibody may directly increase the risk that adenomyosis might develop. It is also possible that the expansion of endometrial glandular tissue, as well as elevated estrogens, during adenomyosis may lead to elevated calreticulin, which induces an autoimmune reaction to it. Further study is required to determine whether there is a significant association between adenomyosis and the prevalence of calreticulin autoantibodies.

Comparison between multidetector computed tomography and hysterosalpingography in assessment of infertile couples

To compare the efficacy of multidetector CT (MDCT) with conventional X-ray hysterosalpingography (HSG) in the evaluation of infertile couples. Thirty-four patients with diagnosis of infertility, were evaluated with 4-row MDCT prior to HSG. All patients underwent diagnostic laparoscopy in the following period. Sensitivity, specificity, negative predictive value and positive predictive value of MDCT and HSG for the detection of tubal obstruction and pelvic adhesions were calculated. Mean duration of the procedure for HSG and MDCT respectively was 26 ± 3.3 and 7 ± 1.1 min. MDCT has shown significantly less patient discomfort and mean effective dose of radiation. MDCT was able to diagnose a case of adenomyosis and a case of ovarian tumor further to HSG. HSG diagnosed two cases of unilateral tubal block, four cases of bilateral tubal block and six cases were suggested as pelvic adhesions due to abnormal smearing at the second film. MDCT diagnosed one case of unilateral tubal block, four cases of bilateral tubal block being unable to detect pelvic adhesions because of lack of delayed imaging. Using laparoscopy as a reference standard; sensitivity, specificity, positive predictive value and negative predictive value of MDCT and HSG in detecting tubal block were as follows: (100%, 96.7%, 83.3% and 100% for MDCT in comparison to 100%, 93.7%, 66.7% and 100% for HSG. Sensitivity, specificity, positive predictive value and negative predictive value of HSG in detecting pelvic adhesions were 42.8%, 88.8%, 50%, and 85.7. This study demonstrated the feasibility of evaluating the female reproductive system by MDCT.