Adenomyoma

Adenomyoma

An adenomyoma is a type of benign tumor that consists of both glandular tissue and smooth muscle tissue. It is most commonly found in the uterus, where it is referred to as adenomyosis, but can also occur in other locations such as the ovary and the gallbladder.

Pathophysiology

Adenomyomas are characterized by the presence of endometrial tissue within the myometrium, the muscular layer of the uterus. This ectopic endometrial tissue can cause the uterus to become enlarged and can lead to symptoms such as dysmenorrhea (painful menstruation) and menorrhagia (heavy menstrual bleeding). The exact cause of adenomyoma formation is not fully understood, but it is thought to be related to hormonal factors and possibly genetic predisposition.

Clinical Presentation

Patients with adenomyomas may present with a variety of symptoms depending on the location of the tumor. In the uterus, symptoms often include pelvic pain, abnormal uterine bleeding, and infertility. When adenomyomas occur in the ovary, they may present as adnexal masses and can be associated with endometriosis. In the gallbladder, adenomyomas are often asymptomatic but can occasionally cause biliary colic or mimic gallstones.

Diagnosis

The diagnosis of adenomyoma is typically made through imaging studies such as ultrasound or magnetic resonance imaging (MRI), which can reveal the characteristic features of the tumor. Histological examination of tissue samples obtained through biopsy or surgical resection is necessary to confirm the diagnosis. The presence of both glandular and smooth muscle components is a key histological feature.

Treatment

Treatment options for adenomyomas depend on the severity of symptoms and the location of the tumor. In cases of uterine adenomyosis, treatment may include hormonal therapies such as oral contraceptives or gonadotropin-releasing hormone agonists to reduce symptoms. Surgical options include hysterectomy or myomectomy for those who wish to preserve fertility. For adenomyomas in other locations, surgical excision may be necessary if the tumor is causing symptoms.

Related Pages

• Adenomyosis
• Endometriosis
• Leiomyoma
• Benign tumor

Gallery

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  Uterine adenomyosis, very high magnification

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  Uterine adenomyosis, intermediate magnification

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  Adenomyoma of the ovary, smooth muscle actin immunostain

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  Rokitansky-Aschoff sinus, gallbladder

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  Adenomyoma of ovary, gross appearance

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  Uterine adenomyosis at very high magnification

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  Uterine adenomyosis at intermediate magnification

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  Adenomyoma of the ovary with smooth muscle actin immunostain

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  Rokitansky-Aschoff sinus in the gallbladder

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  Adenomyoma of ovary (gross)