Abstract
Adenomyosis is defined as the presence of endometrial glands and stroma in the uterine myometrium. It can be diffuse or focal. Diffuse form is commonly seen while focal adenomyotic cyst is a rare entity. Various theories have been proposed regarding its origin. Symptoms associated with it are dysmenorrhea, abnormal uterine bleeding, chronic pelvic pain, and infertility. Adenomyotic cysts should be suspected in cases of refractory dysmenorrhea and is resistant to medical therapy including analgesics or cyclic oral contraceptives. They can be diagnosed with the help of non-invasive imaging techniques as trans-abdominal ultrasound and pelvic MRI and are often managed by surgical treatment. Nowadays, more women are being diagnosed due to advanced age at first pregnancy and availability of better imaging modalities and minimally invasive such as hysteroscopy that has enabled the clinicians not only to diagnose the disease but also its simultaneous management in the office setting.
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References
Brosens I, Gordts S, Habiba M, Benagiano G. Uterine cystic adenomyosis: a disease of younger women. J Pediatr Adolesc Gynecol. 2015;28(6):420–6.
Tamai K, Koyama T, Umeoka S, Saga T, Fujii S, Togashi K. Spectrum of MR features in adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2006;20:583–602.
Dogan E, Gode F, Saatli B. Juvenile cystic adenomyosis mimicking uterine malformation: a case report. Arch Gynecol Obstet. 2008;278(6):593–5.
Kim NR, Cho HY, Ha SY. Intramyometrial uterine cysts with special reference to ultrastructural findings: report of two cases. J Obstet Gynaecol Res. 2011;(3):259–63.
Atri M, Reinhold C, Mehio AR et-al. Adenomyosis: US features with histologic correlation in an in-vitro study. Radiology 2000; 215 (3): 783-790.
Cullen TS. Adenomyoma of the uterus. JAMA. 1908;L(2):107–15.
Cucinella G, Billone V, Pitruzzella I, Lo Monte AI, Palumbo VD, Perino A. Adenomyotic cyst in a 25-year-old woman: case report. J Minim Invasive Gynecol. 2013;20(6):894–8.
Frankl O. Adenomyosis uteri. Am J Obstet Gynecol. 1925;10:680–4.
Bird CC, McElin TW, Manalo-Estrella P. The elusive adenomyosis of the uterus-revisited. Obstet Gynecol. 1972;112:583–93.
Koike N, Tsunemi T, Uekuri C, Akasaka J, Ito F, Shigemitsu A, Kobayashi H. Pathogenesis and malignant transformation of adenomyosis. Oncol Rep. 2013;29(3):861–7.
Leyendecker G, Wildt L, Mall G. The pathophysiology of endometriosis and adenomyosis: tissue injury and repair. Arch Gynecol Obstet. 2009;280:529–53.
Curtis KM, Hillis SD, Marchbanks PA, Peterson HB. Disruption of the endometrial-myometrial border during pregnancy as a risk factor for adenomyosis. Am J Obstet Gynecol. 2002;187:543–4.
Ferenczy A. Pathophysiology of adenomyosis. Hum Reprod Update. 1998;4:312.
Parrott E, Butterworth M, Green A, White IN, Greaves P. Adenomyosis – a result of disordered stromal differentiation. Am J Pathol. 2001;159:623–30.
Benagiano G, Brosens I, Carrara S. Adenomyosis: new knowledge is generating new treatment strategies. Womens Health. 2009;5:297–311.
Sahin AA, Silva EG, Landon G, Ordonez NG, Gershenson DM. Endometrial tissue in myometrial vessels not associated with menstruation. Int J Gynecol Pathol. 1989;8:139–46.
Kitawaki J. Adenomyosis: the pathophysiology of an oestrogen-dependent disease. Best Pract Res Clin Obstet Gynaecol. 2006;20:493–502.
McCarthy S, Scott G, Majumdar S, et al. Uterine junctional zone: MR study of water content and relaxation properties. Radiology. 1989;171:241–3.
Novellas S, Chassang M, Delotte J, Toullalan O, Chevallier A, Bouaziz J, Chevallier P. MRI characteristics of the uterine junctional zone: from normal to the diagnosis of adenomyosis. Am J Roentgenol. 2011;196:1206–13.
Hauth EA, Jaeger HJ, Libera H, Lange S, Forsting M. MR imaging of the uterus and cervix in healthy women: determination of normal values. Eur Radiol. 2007;17:734–42.
Bazot M, Cortez A, Darai E, et al. Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Hum Reprod. 2001;16:2427–33.
Grimbizis GF, Mikos T, Tarlatzis BC. Uterus-sparing operative treatment for adenomyosis. Fertil Steril. 2014;101:472–87.
Dobashi Y, Fiedler PN, Carcangiu ML. Polypoid cystic adenomyosis of the uterus: report of a case. Int J Gynecol Pathol. 1992;11:240–3.
Steinkampf MP, Manning MT, Dharia S, Burke KD. An accessory uterine cavity as a cause of pelvic pain. Obstet Gynecol. 2004;103:1058–61.
Molinas CR, Campo R. Office hysteroscopy and adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2006;20(4):557–67.
Keating S, Quenville NF, Korn GW, et al. Ruptured adenomyotic cyst of the uterus – a case report. Arch Gynecol. 1986;237(3):169–70.
Giana M, Montella F, Surico D, Vigone A, Bozzola C, Ruspa G. Large intramyometrial cystic adenomyosis: a hysteroscopic approach with bipolar resectoscope: case report. Eur J Gynaecol Oncol. 2005;26(4):462–3.
Ryo E, Takeshita S, Shiba M, Ayabe T. Radiofrequency ablation for cystic adenomyosis: a case report. J Reprod Med. 2006;51(5):427–30.
Koga K, Osuga Y, Hiroi H, Oishi H, Kugu K, Yano T, Taketani Y. A case of giant cystic adenomyosis. Fertil Steril. 2006;85(3):748–9.
Wang J, Wu R, Xu K, Lin J. Single large cystic adenomyoma of the uterus after cornual pregnancy and curettage. Fertil Steril. 2007;88(4):965–7.
Takeda A, Sakai K, Mitsui T, Nakamura H. Laparoscopic management of juvenile cystic adenomyoma of the uterus: report of two cases and review of the literature. J Minim Invasive Gynecol. 2007 May–June;14(3):370–4.
Ho ML, Raptis C, Hulett R, et al. Adenomyotic cyst of the uterus in an adolescent. Pediatr Radiol. 2008;38(11):1239–42.
Takeuchi H, Kitade M, Kikuchi I, Kumakiri J, Kuroda K, Jinushi M. Diagnosis, laparoscopic management, and histopathologic findings of juvenile cystic adenomyoma: a review of nine cases. Fertil Steril. 2010;94(3):862–8.
Kriplani A, Mahey R, Agarwal N, Bhatla N, Yadav R, Singh M. Laparoscopic management of juvenile cystic adenomyoma: four cases. J Minim Invasive Gynecol. 2011;18(3):343–8.
Jain N, Goel S. Cystic adenomyoma simulates uterine malformation: a diagnostic dilemma: case report of two unusual cases. J Hum Reprod Sci. 2012;5(3):285–8.
Gordts S, Campo R, Brosens I. Hysteroscopic diagnosis and excision of myometrial cystic adenomyosis. Gynecol Surg. 2014;11:273.
Baba A, Yamazoe S, Dogru M, Ogawa M, Takamatsu K, Miyauchi J. Clear cell adenocarcinoma arising from adenomyotic cyst: a case report and literature review. J Obstet Gynaecol Res. 2016;42(2):217–23.
Lu B, Chen Q, Zhang X, Cheng L. Serous carcinoma arising from uterine adenomyosis/adenomyotic cyst of the cervical stump: a report of 3 cases. Diagn Pathol. 2016;11:46.
Jain N, Manchanda R, Chithra S, Lekhi A. Hysteroscopy: a diagnostic & therapeutic tool for focal adenomyotic cyst. Int J Curr Med Pharm Res. 2016;2(5):307–11.
Nabeshima H, Murakami T, Nishimoto M, Sugawara N, Sato N. Successful total laparoscopic cystic adenomyomectomy after unsuccessful open surgery using transtrocar ultrasonographic guiding. J Minim Invasive Gynecol. 2008;15(2):227–30.
Fedele L, Bianchi S, Frontino G. Hormonal treatments for adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2008;22(2):333–9.
Cucinella G, Granese R, Calagna G, Svelato A, Saitta S, Tonni G, De Franciscis P, Colacurci N, Perino A. Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference? Arch Gynecol Obstet. 2013;288(4):821–7.
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Manchanda, R., Manchanda, P., Meena, J. (2018). Cystic Adenomyosis. In: Tinelli, A., Alonso Pacheco, L., Haimovich, S. (eds) Hysteroscopy. Springer, Cham. https://doi.org/10.1007/978-3-319-57559-9_43
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