adenomyoma
The so-called adenomyoma is one of the manifestations of
adenomyosis
, which is still diagnosed by physicians as adenomyosis, and less often as adenomyoma. Adenomyosis or myoadenoma is a benign condition in which endometrial tissue is present in the muscular layer of the uterus. Clinical diagnosis is based on symptoms, internal diagnosis, tumor index CA-125, and
ultrasound
. Patients usually have a history of dysmenorrhea, which often begins one or two days before the onset of menstruation, lasts throughout the period, and persists for several days after menstruation ends. Some women have a combination of excessive menstrual bleeding,
painful intercourse
and infertility. About half of patients are asymptomatic, however, and after removal of the uterus for other conditions,
pathologic examination
accidentally reveals adenomyosis. Internal examination reveals a diffusely enlarged uterus, usually globular in shape, but rarely larger than the standard size for 12 weeks' gestation. The uterus is enlarged during menstruation and is tender on internal examination, shrinking slightly at the end of menstruation, and the tenderness disappears. Ultrasound examination reveals enlargement of the entire uterus and hypertrophy of the uterine wall, especially the posterior wall, accompanied by an enhanced ultrasound echo. If the myometrium is thickened and integrated into a mass of tumors with strong echogenic characteristics, it is generally called a myometrium. Recently, three-dimensional energy ultrasound has also been used to visualize myometrial
blood flow
stereotyping for diagnostic purposes. In addition, the tumor index CA-125 is sometimes elevated in patients with adenomyosis and can be used as a diagnostic tool. However, the diagnosis can only be made after surgical removal of the uterus or laparoscopic sectioning of the uterus and sending it for
pathologic sectioning
examination.
Prevalence and causes
Adenomyosis is usually found in women between the ages of 30 and 50, especially those going through menopause, and is detected by obstetrics and gynecology exams due to irregular menstruation and excessive menstrual bleeding. The true cause of the disease is unclear,
and there are reports that
Cesarean section scars
and uterine curettage may also contribute to adenomyosis. A section of the surgically removed hypertrophied uterus can be observed to reveal fresh or old myometrial bleeding, a manifestation of ectopic endometrial tissue in the myometrium. Some ectopic endometrial tissue in the myometrium may even have proliferation, secretion, and metaplasia similar to the
menstrual cycle
. Interestingly, about 30
-
50%
of adenomyosis and fibroids and
endometriosis
will be **** together.