Focal adenomyosis (intramural endometriotic cyst) in a very young patient - differential diagnosis with uterine fibromatosis

Introduction. Adenomyosis is a widespread disease usually affecting the late reproductive years of the women's life, which has a great impact on their fertility. The most common form is diffuse adenomyosis, while focal adenomyosis, a cystic variant, is very rare, particularly in patients younge...

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Bibliographic Details
Published in:Journal of medicine and life 2016-04, Vol.9 (2), p.180-182
Main Authors: Manta, L, Suciu, N, Constantin, A, Toader, O, Popa, F
Format: Article
Language:English
Subjects:
Adenomyosis - complications
Adenomyosis - diagnosis
Adenomyosis - diagnostic imaging
Adenomyosis - surgery
Case Presentations
Cysts - complications
Cysts - diagnosis
Cysts - diagnostic imaging
Diagnosis, Differential
Endometriosis - complications
Endometriosis - diagnosis
Endometriosis - diagnostic imaging
Endometriosis - surgery
Female
Humans
Intraoperative Care
Leiomyoma - complications
Leiomyoma - diagnosis
Leiomyoma - diagnostic imaging
Leiomyoma - surgery
Menorrhagia - complications
Ultrasonography, Doppler
Uterine Neoplasms - complications
Young Adult
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Summary:Introduction. Adenomyosis is a widespread disease usually affecting the late reproductive years of the women's life, which has a great impact on their fertility. The most common form is diffuse adenomyosis, while focal adenomyosis, a cystic variant, is very rare, particularly in patients younger than 30 years old. Materials and methods. We reported a rare case of a 20-year-old Caucasian woman with cystic adenomyosis who was admitted in our service with severe chronic pelvic pain, dysmenorrhea, and menorrhagia, who had received conservative surgical treatment to preserve fertility and improve her obstetrical prognosis. Results and Discussions. Although the necrobiosis of a uterine fibroid was suspected preoperatively, the extemporaneous histopathological exam revealed adenomyosis associated with fibroleiomyoma with hyaline dystrophy and multiple foci of endometriosis of cystic formation in the wall of a young woman without any risk factors. Conclusion. Although a rare lesion in young patients, cystic adenomyosis should be considered when chronic pelvic pain is exacerbated during menstruation and is associated with a uterine tumor. In young patients, the differential diagnosis should be made with uterine malformations (hematometra), necrobiosis of uterine fibroids, pelvic endometriosis. The surgical treatment should be conservative with the excision of the lesion, always taking into account fertility preservation in young patients.
ISSN:1844-122X
1844-3117