Updated: 5/19/2020

Adenomyosis

0%
Topic
Review Topic
0
0
N/A
N/A
Questions
3 3
0
0
0%
0%
Evidence
2 2
0
0
https://upload.medbullets.com/topic/111070/images/adenomyosis.jpg
Snapshot
  • A 35-year-old woman with a long history of heavy menses and cramps presents with progressively worsening symptoms over the course of a few month. She has also gained weight. During the interview, she asked about the use of hormonal contraception. On physical exam, the uterus was enlarged, smooth, boggy, and tender. She elected to treat with hormonal contraceptives to preserve fertility instead of undergoing hysterectomy.
Overview


Introduction
  • Invasion of endometrial glands into uterine myometrium  
  • Pathogenesis
    • largely unknown
    • hyperplasia of basalis layer of endometrium
  • Epidemiology
    • women ages 35-50
  • Associated conditions
    • often coexists with other uterine diseases
      • leiomyomas
      • endometriosis
Presentation
  • Symptoms 
    • dysmenorrhea
    • menorrhagia
  • Physical exam
    • uterus is
      • uniformly smooth
      • large
      • soft
      • globular
      • boggy
      • tender
Evaluation
  • nitial test to order in patient with enlarged uterusI
    • β-hCG
  • Diagnosis is based on clinical history and exam
  • Imaging
    • sonogram shows diffusely enlarged uterus with some cystic areas within myometrium
  • Definitive diagnosis with hysterectomy and histology
Differential Diagnosis
  • Leiomyoma
  • Pregnancy
  • Endometrial polyp
Treatment
  • Symptomatic treatment for dysmenorrhea
    • hormonal contraceptives
      • e.g., levonorgestrel-releasing intrauterine contraception
  • When fertility is no longer needed or failure of medical management
    • hysterectomy
Complications
  • Controversial evidence linking adenomyosis with infertility
 

Please rate topic.

Average 4.8 of 9 Ratings

Questions (3)
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK

(M1.RP.13.1) A 40-year-old female presents to her gynecologist with dysmenorrhea, menorrhagia, and pelvic pain. The patient is not taking any medication and has no evidence of fever. Transvaginal sonogram reveals an enlarged, soft, and tender uterus, and uterine biopsy shows normal-appearing endometrial glands within the myometrium. Which of the following is the most likely diagnosis in this patient: Tested Concept

QID: 101664
1

Adenomyosis

51%

(22/43)

2

Endometriosis

21%

(9/43)

3

Endometritis

12%

(5/43)

4

Leiomyoma

9%

(4/43)

5

Endometrial carcinoma

0%

(0/43)

M 2 E

Select Answer to see Preferred Response

Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Evidence (2)
Topic COMMENTS (4)
Private Note