2Introduction: Adenomyosis is the presence of endometrial glands and stroma within the myometrium. The exact pathogenesis of adenomyosis remains unclear, but several theories have been proposed. Common mechanisms include the invasion of the endometrium into the myometrium and the formation of adenomyotic foci from Müllerian remnants. Clinically, adenomyosis typically presents with heavy menstrual bleeding, dysmenorrhea, and diffuse uterine enlargement. However, definitive diagnosis requires histopathological examination, with adenomyosis findings present in 20–30% of hysterectomy specimens. Since a definitive diagnosis necessitates surgical tissue sampling, the exact prevalence of adenomyosis in the general population remains undetermined [1] …

Background: To investigate the incidence of nodular and diffuse adenomyosis, concomitant pathologies and also to compare the demographic and clinic differences among patients with adenomyosis and their surgery indications. Methods: This retrospective study was conducted in Tepecik Research Hospital, Izmir, Turkey between 2014 and 2016. Patients were divided into two groups of nodular and diffuse adenomyosis. The following variables were evaluated for both groups: age, gravidity, parity, menopausal status, indication for hysterectomy, ultrasonographic parameters, gynecological symptoms (abnormal uterine bleeding [AUB], pelvic pain and pelvic pressure, postmenopausal vaginal bleeding), preoperative and postoperative histopathological assessment, and coexisting pathologies. Results: Of the total 3457 cases of hysterectomies, 755 (95% CI: 20. 4– 23. 1) were confirmed with adenomyosis. There were 217 (95% CI: 23. 9– 30. 0) postmenopausal women. Adenomyosis was most commonly detected in patients in the age of 40 to 50 (57. 6%). The most common symptoms were AUB (n: 336) (95% CI: 40. 9– 48. 0), pelvic pain or pressure (n: 139) (18. 4%), and postmenopausal vaginal bleeding (n: 119) (95% CI: 13. 1– 18, 4). Seventy-four (95% CI: 7. 9– 11. 9) of the patients had nodular and 681(95% CI: 88. 0– 92. 3) had diffuse adenomyosis. Demographic data, age, parity, gravidity, endometrial thickness, and menopausal status were similar between the groups. AUB was more frequently detected in nodular adenomyosis (56. 8%). Myoma uteri was the main hysterectomy indication in both groups. In addition, treatment-resistant AUB for nodular adenomyosis and endometrial pathologies for diffuse adenomyosis were the most frequent indications for hysterectomy after myoma uteri. Conclusion: The most common form of adenomyosis was the diffuse form. Endometrial pathologies were more frequently associated with diffuse adenomyosis. Asymptomatic and incidental adenomyosis were more common with the diffuse form. AUB was more frequently detected with nodular adenomyosis.

Adenomyosis is an idiopathic and benign disease in which ectopic endometrial glands embedded deeply in myometrial smooth muscle with the compensatory hypertrophy of the myometrium surrounding the ectopic endometrium (1, 2). There is a correlation between depth of the infiltration and initial too high stage of adenomyosis. Lesions may characterize as a diffuse or focal lesions. The highest prevalence occurs in parous women 30-50 years old and in half of the cases remains asymptomatic (2, 3). By now, there are no definitive detection methods for adenomyosis and the condition still remains a diagnostic challenge. Transvaginal ultrasound (TVS) is the primary imaging modality for preoperative diagnosis of diffuse adenomyosis. ….

Adenomyosis is a widespread disease affecting the reproductive period of women’s life. In the last ten years, different pathogenetic hypotheses have been proposed to explain the initiation and development of the disease. This article aims to present and discuss the most important pathophysiologic mechanisms underlying adenomyosis development in order to clarify the relationship between adenomyosis and infertility. A PubMed search was undertaken for English language literature using the MeSH terms ‘adenomyosis’, ‘infertility’, ‘treatment’, and ‘pathogenesis’. Although the exact etiology of adenomyosis is unknown, many theories have been proposed. We analysed the most important pathogenic theories expressed and evaluated the potential consequences on women fertility. A better comprehension of the adenomyosis pathogenesis has allowed realizing that adenomyosis may affect young women and may have a great impact on their fertility through different mechanisms. The understanding of these mechanisms helps to clarify the potential usefulness of current therapies.

Objective: Endometrial cancer (EC) is the most commonly diagnosed malignancy and has the secondhighest mortality rate among gynecological cancers. Adenomyosis is well-known for abnormal uterine bleeding and is a widely reported entity,however, an EC arising from the adenomyosis is a rare event,even rarer is the occurrence of serous endometrial carcinoma. Case report: A 60-year post-menopausal female presented with post-menopausal bleeding. Subsequently, she underwent a hysterectomy, which showed atrophic and cystic endometrium with extensive adenomyosis and atypical endometrial glands, which are diffusely P53 positive with intervening negative benign and focally positive dysplastic endometrial glands. A final diagnosis of serous endometrial carcinoma arising from adenomyosis was rendered. In a table format, previously reported serous endometrial carcinoma Arising cases from adenomyosis using PubMed search had been described. Conclusion: Serous endometrial carcinoma arising from adenomyosis (<20 cases reported) and has a slightly more dismal prognosis than those deriving from the endometrial cavity. Hence, this case report highlights the occurrence, rarity, and importance of such an entity.

Adenocarcinoma arising from adenomyosis uteri is rare. Herein, we reported a patient with papillary serous carcinoma arising from adenomyosis. The patient was a 61-year-old woman who received tamoxifen for treatment of her breast cancer over the past five years. In hysterectomy specimen taken for investigating her uncontrolled bleeding with suspicion of uterine myoma, multiple adenomyotic foci were found in the uterine wall. In one of these foci, papillary serous carcinoma was found. No evidence of tumor was seen in endometrial surface, peritoneum, and both adnexa.

Background: Adenomyosis is a common benign disorder in premenopausal women. It may be presents with uterus enlargement, pelvic pain, abnormal uterine bleeding and dysmenorrheal. The main objective of this study was to assess prior uterine surgery was a risk factor for adenomyosis.Materials and Methods: In this cross-sectional study, we reviewed the medical records of all women who underwent hysterectomy for benign and nonemergency gynecologic condition between 2001-2006 in Shariate hospital of Bandar Abbas. Data included: age, gravidity, parity, abortion, prior uterine surgery and uterine size by physical examination before hysterectomy, were collected from the clinical records and the information about adenomyosis was obtained from pathology records. Analysis was done using SPSS-16, descriptive statistics, T test and ANOVA. Significant level was set as P<0.05.Results: Of the 191 participants, 72 (37.7%) women had pathologically confirmed adenomyosis. The prevalence of adenomyosis in this study was 37.7%. women with adenomyosis reported a history of prior uterine surgery more frequently than women without adenomyosis but age, menarch, gravidity, parity and history of abortion were similar between the 2 groups.Conclusion: This study indicated that adenomyosis had significant correlation with prior uterine surgery. And, confirmed that we can decrease prevalence of adenomyosis with decreased unnessecery uterine surgery.