Adenomyoma is a tumor (''-oma'') including components derived from

gland A gland is a Cell (biology), cell or an Organ (biology), organ in an animal's body that produces and secretes different substances that the organism needs, either into the bloodstream or into a body cavity or outer surface. A gland may also funct ...

s (''adeno-'') and

muscle Muscle is a soft tissue, one of the four basic types of animal tissue. There are three types of muscle tissue in vertebrates: skeletal muscle, cardiac muscle, and smooth muscle. Muscle tissue gives skeletal muscles the ability to muscle contra ...

(''-my-''). It is a type of complex and mixed tumor, and several variants have been described in the medical literature.

Uterine The uterus (from Latin ''uterus'', : uteri or uteruses) or womb () is the organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic and fetal development of one or more fertilized eggs until bir ...

adenomyoma, the localized form of uterine

adenomyosis Adenomyosis is a medical condition characterized by the growth of cells that proliferate on the inside of the uterus (endometrium) atypically located among the cells of the uterine wall (myometrium), as a result, thickening of the uterus occurs. ...

, is a tumor composed of endometrial gland tissue and

smooth muscle Smooth muscle is one of the three major types of vertebrate muscle tissue, the others being skeletal and cardiac muscle. It can also be found in invertebrates and is controlled by the autonomic nervous system. It is non- striated, so-called bec ...

in the

myometrium The myometrium is the middle layer of the uterine wall, consisting mainly of uterine smooth muscle cells (also called uterine myocytes) but also of supporting stromal and vascular tissue. Its main function is to induce uterine contractions. Stru ...

. Adenomyomas containing endometrial glands are also found outside of the uterus, most commonly on the uterine adnexa but can also develop at distant sites outside of the

pelvis The pelvis (: pelves or pelvises) is the lower part of an Anatomy, anatomical Trunk (anatomy), trunk, between the human abdomen, abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also c ...

Gallbladder In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow Organ (anatomy), organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath t ...

adenomyoma, the localized form of adenomyomatosis, is a polypoid tumor in the gallbladder composed of

hyperplastic Hyperplasia (from ancient Greek ὑπέρ ''huper'' 'over' + πλάσις ''plasis'' 'formation'), or hypergenesis, is an enlargement of an organ or tissue caused by an increase in the amount of organic tissue that results from cell proliferatio ...

mucosal epithelium and

muscularis propria The muscular layer (muscular coat, muscular fibers, muscularis propria, muscularis externa) is a region of muscle in many organs in the vertebrate body, adjacent to the submucosa. It is responsible for gut movement such as peristalsis. The Latin, ...

Classification

Uterine Adenomyoma

Uterine adenomyoma is the focal form of uterine

. Adenomyosis most commonly presents with numerous small collections of endometrial glands and stroma spread diffusely throughout the

, intermixed with the myometrial

. In contrast, a uterine adenomyoma is an isolated nodular mass of endometrial tissue with surrounding smooth muscle, either embedded within the myometrium or extending from the endometrium into the

uterine cavity The uterine cavity is the inside of the uterus The uterus (from Latin ''uterus'', : uteri or uteruses) or womb () is the hollow organ, organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic d ...

in the form of a polyp.

Extrauterine Adenomyoma

Though less common, adenomyomas with endometrial tissue can also be found outside the uterus. The majority of cases of extrauterine adenomyomas described in the literature have been located in the pelvis, growing on the

ovaries The ovary () is a gonad in the female reproductive system that produces ova; when released, an ovum travels through the fallopian tube/oviduct into the uterus. There is an ovary on the left and the right side of the body. The ovaries are endocr ...

, uterine

ligament A ligament is a type of fibrous connective tissue in the body that connects bones to other bones. It also connects flight feathers to bones, in dinosaurs and birds. All 30,000 species of amniotes (land animals with internal bones) have liga ...

s, and space surrounding the rectum. Several cases have been located outside of the pelvis, such as in the liver, appendix, upper abdomen, and

mesentery In human anatomy, the mesentery is an Organ (anatomy), organ that attaches the intestines to the posterior abdominal wall, consisting of a double fold of the peritoneum. It helps (among other functions) in storing Adipose tissue, fat and allowi ...

of the small bowel. There have also been patients with adenomyomas found at multiple locations in the body.

Gallbladder Adenomyoma

Gallbladder adenomyomatosis is a

benign Malignancy () is the tendency of a medical condition to become progressively worse; the term is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous benign tumor, ''benign'' tumor in that a malig ...

disease of the gallbladder characterized by

hyperplasia Hyperplasia (from ancient Greek ὑπέρ ''huper'' 'over' + πλάσις ''plasis'' 'formation'), or hypergenesis, is an enlargement of an organ or tissue caused by an increase in the amount of Tissue (biology), organic tissue that results from ...

of the mucosal epithelium and smooth muscle cells inside the

. The excessive proliferation of epithelial cells causes the mucosa to invaginate into the muscular layer lining the gallbladder wall, resulting in characteristic

diverticula In medicine or biology, a diverticulum is an outpouching of a hollow (or a fluid-filled) structure in the body. Depending upon which layers of the structure are involved, diverticula are described as being either true or false. In medicine, t ...

known as Rokitansky-Aschoff sinuses. These sinuses may be filled with

biliary sludge A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. The bile duct is separated into three main parts: the fundus (superior), the body (middle), and the neck (inferior). Bile is requ ...

, cholesterol crystals, or

gallstone A gallstone is a stone formed within the gallbladder from precipitated bile components. The term cholelithiasis may refer to the presence of gallstones or to any disease caused by gallstones, and choledocholithiasis refers to the presence of ...

s. There are three morphologic variants described in the literature – diffuse, segmental, and localized. Diffuse, also known as generalized, adenomyomatosis has a widespread distribution of hyperplastic changes and thickening across the gallbladder wall. The localized form of adenomyomatosis is also known as a gallbladder adenomyoma (in a similar manner that uterine adenomyoma is the localized variant of adenomyosis). The localized form is a single mass, typically in the

fundus ''Fundus'' (Latin for "bottom") is an anatomical term referring to that part of a concavity in any organ, which is at the far end from its opening. It may refer to: Anatomy * Fundus (brain), the deepest part of any sulcus of the cerebral cortex * F ...

, that protrudes into the lumen of the gallbladder in the form of a polyp. The segmental form is characterized by its annular (ring-shaped) distribution of adenomyomatosis in the

body Body may refer to: In science * Physical body, an object in physics that represents a large amount, has mass or takes up space * Body (biology), the physical material of an organism * Body plan, the physical features shared by a group of anim ...

of the gallbladder, often giving it an hourglass-like appearance.

Signs and symptoms

Uterine Adenomyoma

The clinical features of uterine adenomyosis vary widely and may include

dysmenorrhea Dysmenorrhea, also known as period pain, painful periods or menstrual cramps, is pain during menstruation. Its usual onset occurs around the time that menstruation begins. Symptoms typically last less than three days. The pain is usually in th ...

pelvic pain Pelvic pain is pain in the area of the pelvis. Acute (medicine), Acute pain is more common than chronic pain. If the pain lasts for more than six months, it is deemed to be chronic pelvic pain. It can affect both the male and female pelvis. Common ...

menorrhagia Heavy menstrual bleeding (HMB), previously known as menorrhagia or hematomunia, is a menstrual period with excessively heavy flow. It is a type of abnormal uterine bleeding (AUB). Abnormal uterine bleeding can be caused by structural abnorm ...

, and/or

infertility In biology, infertility is the inability of a male and female organism to Sexual reproduction, reproduce. It is usually not the natural state of a healthy organism that has reached sexual maturity, so children who have not undergone puberty, whi ...

, with about one in three affected women remaining asymptomatic. Women with uterine adenomyomas (focal adenomyosis) more commonly have co-existing

endometriosis Endometriosis is a disease in which Tissue (biology), tissue similar to the endometrium, the lining of the uterus, grows in other places in the body, outside the uterus. It occurs in women and a limited number of other female mammals. Endomet ...

and a higher likelihood of infertility compared to women presenting with diffuse adenomyosis. However, a causal link between adenomyomas and the development of infertility has not been established, and further investigation is needed.

Extrauterine Adenomyoma

The most frequent complaint in cases of extrauterine adenomyomas is pain in the pelvis or abdomen, with a small proportion of women also presenting with abnormal bleeding and/or infertility. In half the cases described in the literature, the patient had a history of gynecologic surgery before diagnosis, and several patients also had a medical history of endometriosis.

Gallbladder Adenomyoma

Most patients with adenomyomatosis are asymptomatic. Among symptomatic patients, the most common symptom is abdominal pain in the right upper quadrant or epigastrium. Patients may also present with nausea, dyspepsia, or fatty food intolerance, likely due to altered flow of bile. Some data suggest that the features of clinical presentation may frequently differ based on the variant of adenomyomatosis, as the diffuse and segmental forms appear to have more significant inflammation and a higher incidence of gallstones compared to the localized form. Other symptoms are often related to frequently co-occurring gallbladder diseases such as gallstones, cholecystitis, and choledocholithiasis. These may present with fever, pain,

jaundice Jaundice, also known as icterus, is a yellowish or, less frequently, greenish pigmentation of the skin and sclera due to high bilirubin levels. Jaundice in adults is typically a sign indicating the presence of underlying diseases involving ...

, or other symptoms.

Causes

Uterine Adenomyoma

The underlying cause is not fully understood. A prominent theory is the invagination theory, in which tissue injuries and inflammatory changes due to chronic uterine contractions allow endometrial tissue to pass into the neighboring myometrium. Based on differences in the

protein Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residue (biochemistry), residues. Proteins perform a vast array of functions within organisms, including Enzyme catalysis, catalysing metab ...

s expressed in adenomyomas located in the inner part of the myometrium versus the outer part of the myometrium, it is possible that adenomyomas can also result from the invasion of ectopic endometrial cells originating from nearby regions of endometriosis.

Extrauterine Adenomyoma

No exact risk factors have been described for adenomyomas that develop outside the uterus. A history of prolonged hormone therapy is reported in two cases of patients diagnosed with an extrauterine adenomyoma, including

estrogen Estrogen (also spelled oestrogen in British English; see spelling differences) is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three ...

and a gonadotropin releasing hormone (GnRH) agonist. Though adenomyosis has demonstrated sensitivity to estrogen, further investigation is needed to explore the relationship between hormone therapy and extrauterine adenomyomas. Several theories have been hypothesized to explain the pathogenesis. One theory describes extrauterine adenomyomas resulting from an error in

Müllerian duct The paramesonephric ducts (or Müllerian ducts) are paired ducts of the embryo in the reproductive system of humans and other mammals that run down the lateral sides of the genital ridge and terminate at the sinus tubercle in the primitive uroge ...

fusion during embryonic development, resulting in an abnormal uterus containing a horn-like structure. This horn may then be prone to breaking away and depositing elsewhere, later developing into an adenomyoma. As errors in Müllerian duct fusion also impact the development of the kidneys, urinary tract, and genitals, this theory would explain the multiple cases of extrauterine adenomyomas with co-existing

congenital abnormalities A birth defect is an abnormal condition that is present at birth, regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can range from mild to severe. Birth de ...

of these anatomic structures. Another theory suggests that extrauterine adenomyomas may result from smooth muscle

metaplasia Metaplasia () is the transformation of a cell type to another cell type. The change from one type of cell to another may be part of a normal maturation process, or caused by some sort of abnormal stimulus. In simplistic terms, it is as if the ...

in areas of pre-existing endometriosis. In this theory, areas of endometrial tissue that have developed outside the uterus (endometriosis) undergo cellular changes that provide the muscular component of the adenomyoma.

Gallbladder Adenomyoma

The specific cause of gallbladder adenomyomatosis remains unclear. Some of the risk factors for gallstone formation have also been reported in patients with adenomyomatosis such as

hemolytic disease Hemolytic anemia or haemolytic anaemia is a form of anemia due to hemolysis, the abnormal breakdown of red blood cells (RBCs), either in the blood vessels (intravascular hemolysis) or elsewhere in the human body (extravascular). This most commonl ...

, congenital

biliary A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. The bile duct is separated into three main parts: the fundus (superior), the body (middle), and the neck (inferior). Bile is requ ...

abnormalities, obesity, and

inflammatory bowel disease Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine, with Crohn's disease and ulcerative colitis (UC) being the principal types. Crohn's disease affects the small intestine and large intestine ...

, but whether these are also risk factors for adenomyomatosis requires further investigation. The disease is currently thought to be a degenerative process and unlikely to be the result of congenital malformation. The cell proliferation seen in adenomyomatosis is theorized to result from increased pressure inside the gallbladder due to abnormal muscle contractions or excessive absorption of bile by the gallbladder wall.

Diagnosis

Uterine Adenomyoma

The most common diagnostic imaging modalities for uterine adenomyosis include

transvaginal ultrasonography Vaginal ultrasonography is a medical ultrasonography that applies an ultrasound transducer (or "probe") in the vagina to visualize organs within the pelvic cavity. It is also called transvaginal ultrasonography because the ultrasound waves go ''a ...

(TVS) and

magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...

(MRI). Though surgical excision and microscopic examination of the tumor allow for a definitive diagnosis, these imaging studies offer a non-invasive approach and have a sufficient resolution for a diagnosis. Diagnosis with transvaginal ultrasonography can potentially be challenging due to the similar appearance of uterine leiomyomas (also known as uterine fibroids). Careful evaluation of the margins of the mass, the vascular flow patterns through the tumor, and the degree to which the tumor distorts the uterus may aid in differentiating these masses with ultrasound. MRI is highly effective at distinguishing between uterine adenomyomas and leiomyomas.

Extrauterine Adenomyoma

The most common imaging techniques include ultrasound,

computed tomography A computed tomography scan (CT scan), formerly called computed axial tomography scan (CAT scan), is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or ...

(CT), and MRI.

Intravenous pyelography Pyelogram (or pyelography or urography) is a form of imaging of the renal pelvis and ureter. Types include: * Intravenous pyelogram – In which a contrast solution is introduced through a vein into the circulatory system. * Retrograde pyelogra ...

(IVP) has also been used in some cases to assess for possible congenital anomalies of the kidneys. The appearance of these rare tumors on diagnostic imaging has not been extensively described, and in each case documented in the literature, the diagnosis was ultimately made after surgical removal using

histologic Histology, also known as microscopic anatomy or microanatomy, is the branch of biology that studies the microscopic anatomy of biological tissues. Histology is the microscopic counterpart to gross anatomy, which looks at larger structures visi ...

analysis. On microscopic examination, patterns of smooth muscle and endometrial tissue must be assessed with care to differentiate adenomyomas from masses of similar appearances, such as endometriosis containing smooth muscle and leiomyomas containing endometriosis.

Gallbladder Adenomyoma

Adenomyomatosis is frequently associated with gallstones and is often diagnosed incidentally, either from a

cholecystectomy Cholecystectomy is the surgical removal of the gallbladder. Cholecystectomy is a common treatment of symptomatic gallstones and other gallbladder conditions. In 2011, cholecystectomy was the eighth most common operating room procedure performed i ...

specimen or

autopsy An autopsy (also referred to as post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of deat ...

. No serologic test exists to specify adenomyomatosis and laboratory studies are often normal. Co-existing diseases like

cholecystitis Cholecystitis is inflammation of the gallbladder. Symptoms include Right upper quadrant (abdomen), right upper abdominal pain, pain in the right shoulder, nausea, vomiting, and occasionally fever. Often gallbladder attacks (biliary colic) precede ...

may result in abnormal test results, such as elevated levels of white blood cells (

leukocytosis Leukocytosis is a condition in which the white cell (leukocyte) count is above the normal range in the blood. It is frequently a sign of an inflammatory response, most commonly the result of infection, but may also occur following certain parasit ...

), liver enzymes (

transaminitis In medicine, the presence of elevated transaminases, commonly the transaminases alanine transaminase (ALT) and aspartate transaminase (AST), may be an indicator of liver dysfunction. Other terms include transaminasemia, and elevated liver enzymes ...

), or bilirubin (

hyperbilirubinemia Bilirubin (BR) (adopted from German, originally bili—bile—plus ruber—red—from Latin) is a red-orange compound that occurs in the normcomponent of the straw-yellow color in urine. Another breakdown product, stercobilin, causes the brown ...

). Ultrasound is the preferred initial diagnostic choice for suspected gallbladder disease. Several distinct features of adenomyomatosis are discernable using ultrasound, making it a reliable modality for diagnosis. The most characteristic features seen on ultrasound are the Rokitansky-Aschoff sinuses, which present either as

echogenic Echogenicity (sometimes as echogenecity) or echogeneity is the ability to bounce an echo, e.g. return the signal in medical ultrasound examinations. In other words, echogenicity is higher when the surface bouncing the sound echo reflects increase ...

foci when filled with biliary sludge/gallstones or anechogenic foci when filled with normal bile. Other key features that may be seen include wall thickening and ring-down artifacts known as "comet tails" (produced by reverberations of sound between the sinuses). Ultrasound can also distinguish between diffuse, segmental, and localized variants of adenomyomatosis based on morphology. In some cases, gallbladder wall thickening may be seen on ultrasound but is poorly defined and lacking specificity, particularly if the characteristic Rokitansky-Aschoff sinuses are not visualized. This can make it difficult to distinguish adenomyomatosis from other conditions that result in gallbladder wall thickening such as gallbladder cancer. In these cases, MRI can prove helpful in providing the resolution needed for diagnosis. Especially effective is the T2-weighted MRI at visualizing the pathognomonic Rokitansky-Aschoff sinuses, which appear as round-shaped

hyperintense A hyperintensity or T2 hyperintensity is an area of high intensity on types of magnetic resonance imaging (MRI) scans of the brain of a human or of another mammal that reflect lesions produced largely by demyelination and axonal loss. These smal ...

cystic spaces that align in a curvilinear fashion along the gallbladder wall in a pattern described as the ”pearl necklace sign”.

Treatment

Uterine Adenomyoma

Multiple medical and surgical approaches have been explored to treat uterine adenomyomas, and a patient’s symptoms and reproductive preferences must be considered carefully when choosing the most appropriate therapy. Medical treatments include

nonsteroidal anti-inflammatory drug Non-steroidal anti-inflammatory drugs (NSAID) are members of a Indication (medicine), therapeutic drug class which Analgesic, reduces pain, Anti-inflammatory, decreases inflammation, Antipyretic, decreases fever, and Antithrombotic, prevents bl ...

s (NSAIDs) used for pelvic and menstrual pain and hormonally active medications such as progestins, estrogen-containing contraceptives, and gonadotropin releasing hormone agonists. These hormonal drugs target sex hormones that help govern the growth of endometrial tissue found in adenomyomas. A variety of effective procedures are also available if medical therapy is unsuccessful. These include minimally invasive procedures like

high-intensity focused ultrasound High-intensity focused ultrasound (HIFU), or MR-guided focused ultrasound surgery (MR-guided focused ultrasound ablation), is an incisionless therapeutic technique that uses non-ionizing ultrasonic waves to heat or ablate tissue. HIFU can be us ...

uterine artery embolization Uterine artery embolization (UAE, uterine fibroid embolization, or UFE) is a procedure in which an interventional radiologist uses a catheter to deliver small particles that block the blood supply to the uterine body. The procedure is primarily do ...

and more invasive options such as

endometrial ablation Endometrial ablation is a surgical procedure that is used to remove ( ablate) or destroy the endometrial lining of the uterus. The goal of the procedure is to decrease the amount of blood loss during menstruation (periods). Endometrial ablation i ...

hysterectomy Hysterectomy is the surgical removal of the uterus and cervix. Supracervical hysterectomy refers to removal of the uterus while the cervix is spared. These procedures may also involve removal of the ovaries (oophorectomy), fallopian tubes ( salpi ...

. Adenomyomectomy, a conservative surgery that removes the localized tumor but leaves the surrounding healthy uterus intact, is a potential uterine-sparing option for women with a uterine adenomyoma who wish to preserve their fertility, as some of the previously listed interventions decrease or eliminate the probability of successful future childbearing.

Extrauterine Adenomyoma

Surgical intervention serves as the main diagnostic and treatment approach. The surgical technique applied for tumor excision highly depends on the mass’s location, with gynecologic surgeries such as hysterectomy and

salpingo-oophorectomy In medicine, salpingo-oophorectomy is the removal of an ovary and its fallopian tube. This procedure is most frequently associated with prophylactic surgery in response to the discovery of a BRCA mutation, particularly those of the normally tumo ...

a common choice for pelvic adenomyomas. Hormone therapy has also been combined with surgery in several cases, such as gonadotropin releasing hormone agonists, progesterone, and

aromatase inhibitor Aromatase inhibitors (AIs) are a class of drugs used in the treatment of breast cancer in postmenopausal women and in men, and gynecomastia in men. They may also be used off-label to reduce estrogen conversion when supplementing testosterone exo ...

Gallbladder Adenomyoma

Cholecystectomy, or surgical removal of the gallbladder, is the recommended treatment for patients with symptomatic adenomyomatosis. There is a lack of consensus as to the optimal management of asymptomatic patients, largely due to uncertainties about the possible role of adenomyomatosis in the development of gallbladder cancer. Several sources recommend surgery in cases where adenomyomatosis is difficult to distinguish from malignancy on diagnostic imaging. If well visualized diagnostically, the morphology of the lesion (diffuse/segmental/localized forms) may be an important factor in deciding between a surgical and conservative approach.

Prognosis

Uterine Adenomyoma

Although several treatments have demonstrated long-term improvements in symptoms such as pelvic pain and menorrhagia, there is no clear consensus on the optimal treatment based on the type of adenomyosis, and few studies distinguish between diffuse and focal adenomyosis. Though uterine-sparing surgery is not feasible for diffuse adenomyosis because of the widespread distribution of disease throughout the uterus, it is a possibility for focal adenomyosis due to the localized nature of the adenomyoma. However, these surgeries are performed with caution due to the complexity and potential for uterine rupture due to loss of tensile strength after surgery. There are a small number of studies that have demonstrated improved outcomes in pregnancy when combining conservative surgery with GnRH agonist therapy compared to either method alone. Patients with adenomyosis have been found to have lower successful live birth rates and higher rates of

miscarriage Miscarriage, also known in medical terms as a spontaneous abortion, is an end to pregnancy resulting in the loss and expulsion of an embryo or fetus from the womb before it can fetal viability, survive independently. Miscarriage before 6 weeks ...

following

in vitro fertilization In vitro fertilisation (IVF) is a process of fertilisation in which an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating the ovulatory process, then removing an ovum or ova (egg or eggs) from ...

(IVF) compared to those without adenomyosis. Multiple studies have investigated the impact of GnRH agonist therapy on in vitro fertilization success in patients with adenomyosis. One study assessing patients with adenomyosis receiving fresh

embryo transfer Embryo transfer refers to a step in the process of assisted reproduction in which embryos are placed into the uterus of a female with the intent to establish a pregnancy. This technique - which is often used in connection with in vitro fertili ...

demonstrated different outcomes between diffuse and focal adenomyosis when treated with prolonged GnRH therapy prior to in vitro fertilization. Women with diffuse adenomyosis had higher pregnancy and live birth rates following prolonged GnRH therapy, whereas women with focal adenomyosis demonstrated no benefit. However, there are other studies with conflicting data based on the method of embryo transfer (such as frozen-thawed embryo transfer versus fresh embryo transfer) and no optimized treatment protocol has been established for patients with adenomyosis receiving fertility treatment. In the case of juvenile cystic adenomyoma, laparoscopic enucleation results in a statistically and clinically significant reduction in dysmenorrhea, ease in any chronic pelvic pain, and low risk of recurrence.

Extrauterine Adenomyoma

Long-term outcomes after treatment are sparsely represented in prior studies, though a small number of cases reported recurrence of adenomyomas after surgery. In addition, some patients with extrauterine adenomyomas, particularly of the ovaries and uterine ligaments, also presented with

malignant Malignancy () is the tendency of a medical condition to become progressively worse; the term is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous benign tumor, ''benign'' tumor in that a malig ...

growths in the ovaries or uterus.

Gallbladder Adenomyoma

Though itself considered a benign disease, the potential role of gallbladder adenomyomatosis in the

carcinogenesis Carcinogenesis, also called oncogenesis or tumorigenesis, is the formation of a cancer, whereby normal cell (biology), cells are malignant transformation, transformed into cancer cells. The process is characterized by changes at the cellular, G ...

of gallbladder cancer remains unclear. Previous studies have highlighted several cases of adenomyomatosis associated with gallbladder malignancy, with a particularly strong correlation between segmental adenomyomatosis and

gallbladder carcinoma Gallbladder cancer is a relatively uncommon cancer, with an incidence of fewer than 2 cases per 100,000 people per year in the United States. It is particularly common in central and South America, central and eastern Europe, Japan and northern Ind ...

. Further studies are required to further elucidate the relationship between adenomyomatosis and cancer.

Epidemiology

Uterine Adenomyoma

Data collected from over 300,000 women in the United States suggest an incidence of about 1% for adenomyosis. The

demographic Demography () is the statistics, statistical study of human populations: their size, composition (e.g., ethnic group, age), and how they change through the interplay of fertility (births), mortality (deaths), and migration. Demographic analy ...

with the highest incidence in this

retrospective cohort study A retrospective cohort study, also called a historic cohort study, is a longitudinal cohort study used in medical and psychological research. A cohort of individuals that share a common exposure factor is compared with another group of equivale ...

were black women and women aged 40–45 years, with women in their early 40s the most likely to be symptomatic.

Extrauterine Adenomyoma

Much less common than the intrauterine counterpart, one review found 34 cases of extrauterine adenomyoma described in the literature. The ages of affected women at diagnosis have had a wide range from 17 to 70 years.

Gallbladder Adenomyoma

Adenomyomatosis is discovered in approximately 5% of cholecystectomy specimens. Most patients who are diagnosed are in their 50s or older, with a rare few cases found in children.

References

External links

{{Genital neoplasia Gynaecological neoplasia

Classification

Uterine Adenomyoma

Extrauterine Adenomyoma

Gallbladder Adenomyoma

Signs and symptoms

Uterine Adenomyoma

Extrauterine Adenomyoma

Gallbladder Adenomyoma

Causes

Uterine Adenomyoma

Extrauterine Adenomyoma

Gallbladder Adenomyoma

Diagnosis

Uterine Adenomyoma

Extrauterine Adenomyoma

Gallbladder Adenomyoma

Treatment

Uterine Adenomyoma

Extrauterine Adenomyoma

Gallbladder Adenomyoma

Prognosis

Uterine Adenomyoma

Extrauterine Adenomyoma

Gallbladder Adenomyoma

Epidemiology

Uterine Adenomyoma

Extrauterine Adenomyoma

Gallbladder Adenomyoma

See also

References

External links