Uterine adenomyoma is a benign mass formed by the invasion of the myometrium by endometrial cells. Adenomyoma is a focal part of the related diffuse condition called adenomyosis. Treatment may be surgical (excision of the mass alone, or hysterectomy for women who do not wish to become pregnant), or medical by administration of gonadotropin-releasing hormone agonists.
Uterine adenomyoma is a collection of endometrial glands, which are bordered by two consecutive layers of cells, the first derived from endometrial stroma and the second, outermost one, formed by leiomyomatous smooth muscle cells. Adenomyoma is believed to develop with endometrial glandular and stromal cells invading the myometrium . Adenomyosis is defined in a similar way, but it affects a larger region of the uterus. Adenomyoma is regarded by some as a focal region within the larger area of adenomyosis, and by others as a different version of the condition. Adenomyoma may be difficult to distinguish from uterine fibroids.
Adenomyoma is not a frequent uterine lesion. Of the samples obtained by hysterectomy, twenty percent show evidence of adenomyosis, but the solid focal forms, i.e. adenomyomas, are rare , and the cystic forms even more so. Adenomyomas are usually firm , but can sometimes be soft. Most identified adenomyomas are in the corpus of the uterus  . In one study close to 50% of the patients with adenomyomas also had fibroids . Adenomyomas may be polypoid, - as was the case in an older woman treated with tamoxifen for breast cancer - or may present as cystic lesions, either adult or juvenile type  . Decidualization of adenomyomas has also been observed in a pregnant woman .
The most frequent symptoms are abnormal vaginal bleeding , chronic pelvic pain, and dyspareunia . Serious cases may lead to infertility. Cystic forms of adenomyoma are characterized by severe dysmenorrhea  . These symptoms also accompany other conditions that can coexist with adenomyomas, such as uterine fibroids and endometriosis .
Entire Body System
- Vaginal Bleeding
bleeding is the most common presenting feature Terminology Adenomyoma, cystic adenomyoma, polypoid adenomyoma Clinical features Presents as abnormal vaginal bleeding Severe cases in young women can manifest with infertility Diagnosed with radiology and [pathologyoutlines.com]
Two presented with abnormal vaginal bleeding, but, in most patients, the cervical tumors did not cause symptoms. [ncbi.nlm.nih.gov]
The most common presenting symptom was abnormal vaginal bleeding (n 15). Thirteen patients underwent panhysterectomy; 7, total hysterectomy; 1, subtotal hysterectomy; 4, polypectomy or tumor removal; and 1, curettage. [journals.lww.com]
The most frequent symptoms are abnormal vaginal bleeding, chronic pelvic pain, and dyspareunia. Serious cases may lead to infertility. Cystic forms of adenomyoma are characterized by severe dysmenorrhea. [symptoma.com]
Clinical diagnosis is not feasible since the symptoms are not specific. Adenomyomas are characterized histologically. Histopathologic examination of biopsies reveals lesions consisting of glands and cysts surrounded by endometrial epithelium, stroma, and smooth muscle cells. Distinguishing adenomyoma from atypical polypoid adenomyoma or adenosarcoma may be problematic . An adenomyoma invaded by lymphocytes has been described that structurally resembled a lymphoma, and might have been misdiagnosed as such .
A suspicion of adenomyosis (including adenomyomas) is usually first followed up by ultrasound techniques. Transabdominal sonography has a sensitivity of only 32.5%– 63%  and is not regarded as a dependable method , but transvaginal sonography shows higher accuracy in diagnosis . According to some sources , transvaginal sonography can be as sensitive as magnetic resonance (MR) imaging. A hysterosalpingogram can detect the expansion of diverticula into the myometrium . Computed tomography cannot satisfactorily diagnose adenomyosis, or differentiate it from fibroids.
Changes in the thickness of the endometrium-myometrium junctional zone are characteristic of both diffuse and focal forms of adenomyosis. The thickness of the junctional zone can be examined by both two- or three dimensional transvaginal ultrasound or by MR imaging; a junctional zone thicker than 12 mm indicates adenomyosis. Adenomyoma, situated in the myometrium, has a round shape and low signal intensity on T2 weighted MR imaging, but often with small regions of high intensity .
OBJECTIVE: To compare the efficacy of surgical-medical treatment and surgery alone in the treatment of uterine symptomatic adenomyoma. DESIGN: Prospective nonrandomized study. SETTING: Medical centers. [ncbi.nlm.nih.gov]
Hysterectomy, through either exploratory laparotomy or minimally invasive procedures, is a definite treatment for uterine adenomyosis, once the women have completed childbirth or do not require future fertility. [tmu.pure.elsevier.com]
The 18 subjects were retrospectively divided into treatment group (achieving this pregnancy by treatment; 10 cases) and control group (having no difficulty conceiving; 8 cases). [popline.org]
In the clinical parterre, novel methods of conservative treatments have been developed to allow many women to keep their reproductive capacity and to save uterus, and more novel treatments are available on the horizon. [books.google.com]
[…] cystic change the region may also have a striated appearance 5 T1 C (Gd) contrast-enhanced MRI evaluation is usually not indicated for evaluation of adenomyosis, however, if performed, it shows enhancement of the ectopic endometrial glands Treatment and prognosis [radiopaedia.org]
Prognosis Adenomyosis is a benign proliferation of endometrial tissue. Symptoms usually resolve after menopause. Hysterectomy is curative. [unboundmedicine.com]
Diagnosis and prognosis of leiomyosarcomas. Arch Pathol 1966; 82 : 40–4. 3. Kempson R, Bari W. Uterine sarcomas: classification, diagnosis and prognosis. Hum Pathol 1970; 1 : 331–49. 4. O'Connor D, Norris H. [nature.com]
Three theories have been offered to explain their etiology: 1) the uterine/Mullerian duct fusion defect theory, which is based on a developmental abnormality occurring during the formation of the female genital tract, 2) the metaplastic theory, which [jpatholtm.org]
Etiologies of Acute Abnormal Uterine Bleeding The etiologies of acute AUB, which can be multifactorial, are the same as the etiologies of chronic AUB. [acog.org]
The diagnosis of uterine adenomyoma is usually straightforward, but occasional cases create diagnostic difficulty, and malignancies of epithelial or mesenchymal origin may be considered.  Two theories have been offered to explain the etiology of the [ccij-online.org]
Although the two diseases have distinct epidemiological features, they have the same 'target tissue' for hormonal therapy, namely ectopic endometrium. [2womenshealth.com]
Adenomyosis: epidemiology, risk factors, clinical phenotype and surgical and interventional alternatives to hysterectomy. Geburtshilfe Frauenheilkd. 2013;73(9):924–931. [PMID:24771944] Exacoustos C, Manganaro L, Zupi E. [unboundmedicine.com]
Epidemiological data indicate that parity, caesarean section, induced abortion, dilatation and curettage, uterine malformation and late age at menarche may be the risk factors for adenomyosis development.  The need for hysterectomy to diagnose adenomyosis [jebmh.com]
Epidemiology Adenosarcoma occurs in females aged 15-90 years, with a median age at diagnosis of 58 years. [2, 3, 4, 5, 6, 7, 8, 9] Most patients diagnosed with adenosarcoma are postmenopausal, but one third are of reproductive age. [emedicine.medscape.com]
The reason these two have been broken into separate conditions is due in large part to the epidemiology. Endometriosis is often found in younger women whereas adenomyosis usually develops in the 40’s and 50’s. [medicalvs.com]
Recent research on the genomics and molecular biology of myomas has enabled us to better understand the pathogenesis and pathophysiology of this benign tumor, but more remains to be discovered. [books.google.com]
Aetiology & Pathophysiology Adenomyosis describes the presence of endometrial tissue with the myometrium of the uterus. [teachmeobgyn.com]
Etiology and Pathophysiology Adenomyosis has been described as an abnormal ingrowth and invagination of the basal endometrium into the inner layer of the myometrium (junctional zone [JZ]). [unboundmedicine.com]
Adenomyosis: the pathophysiology of an oestrogen-dependent disease. Best Pract Res Clin Obstet Gynaecol, 2006. 20(4): p. 493-502. [en.wikipedia.org]
Since the adenomyotic nodules communicate with the uterine cavity ( Otto, 1957 ), pathophysiologically a continuous process from initial to deep infiltration must exist. [academic.oup.com]
Current medical research has not established a way of preventing Adenomyoma of Uterine Corpus. [dovemed.com]
Or you've unknowingly prevented bots and search engines from crawling and indexing your pages. An unusually high number could be an indication of duplicate content due to URL parameters. [woorank.com]
Uterine artery embolization This is a procedure that prevents certain arteries from supplying blood to the affected area. With the blood supply cut off, the adenomyosis shrinks. [healthline.com]
Centers for Disease Control and Prevention (CDC). MMWR Recomm Rep 2010;59(RR-4):1–86. [PubMed] [Full Text] Update to CDC’s U.S. [acog.org]
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