Adenomyosis as a Risk Factor for Myometrial or Endometrial Neoplasms—Review

Szubert, Maria; Koziróg, Edward; Wilczyński, Jacek R.

doi:10.3390/ijerph19042294

Cited by 12 publications

(18 citation statements)

References 55 publications

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“…Some studies have even claimed that these conditions are related, but they have not shown consistent results nor reached an accurate conclusion yet. [ 33 , 34 ]…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have even claimed that these conditions are related, but they have not shown consistent results nor reached an accurate conclusion yet. [33,34] The association between adenomyosis and other diseases still requires extensive clinical and molecular investigation. However, in any situation, the presence of adenomyosis does not exclude the possibility of comorbid diseases, so if there are symptoms such as abnormal uterine bleeding, efforts should be made to initially exclude adenomyosis as the primary cause.…”

Section: Discussionmentioning

confidence: 99%

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Clinical efficacy of a novel method of fertility-preserving adenomyomectomy in infertile women with diffuse adenomyosis

et al. 2023

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Beneficial and detrimental effect of surgical adenomyomectomy is still controversial in infertile women with severely diffuse adenomyosis. The primary objective of this study was to assess whether a novel method of fertility-preserving adenomyomectomy could improve pregnancy rates. The secondary objective was to evaluate whether it could improve dysmenorrhea and menorrhagia symptoms in infertile patients with severe adenomyosis. A prospective clinical trial was conducted between December 2007 and September 2016. Fifty women with infertility due to adenomyosis were enrolled in this study after clinical assessments by infertility experts. A novel method of fertility-preserving adenomyomectomy was performed on 45 of 50 patients. The procedure included T- or transverse H-incision of the uterine serosa followed by preparation of the serosal flap, excision of the adenomyotic tissue using argon laser under ultrasonographic monitoring, and a novel technique of suturing between the residual myometrium and serosal flap. After the adenomyomectomy, the changes in the amount of menstrual blood, relief of dysmenorrhea, pregnancy outcomes, clinical characteristics, and surgical features were recorded and analyzed. All patients obtained dysmenorrhea relief 6 months postoperatively (numeric rating scale [NRS]; 7.28 ± 2.30 vs 1.56 ± 1.30, P < .001). The amount of menstrual blood decreased significantly (140.44 ± 91.68 vs 66.33 ± 65.85 mL, P < .05). Of the 33 patients who attempted pregnancy postoperatively, 18 (54.5%) conceived either by natural means, in vitro fertilization and embryo transfer (IVF-ET), or thawing embryo transfer. Miscarriage occurred in 8 patients, while 10 (30.3%) had viable pregnancies. This novel method of adenomyomectomy resulted in improved pregnancy rates, as well as relief of dysmenorrhea and menorrhagia. This operation is effective in preserving fertility potential in infertile women with diffuse adenomyosis

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“…Some studies have even claimed that these conditions are related, but they have not shown consistent results nor reached an accurate conclusion yet. [ 33 , 34 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of a novel method of fertility-preserving adenomyomectomy in infertile women with diffuse adenomyosis

et al. 2023

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“…Szubert et al in the review of adenomyosis as a risk factor for myometrial or endometrial neoplasms concluded that adenomyosis may be a potential risk factor for myometrial or endometrial neoplasms [15].…”

Section: Discussionmentioning

confidence: 99%

Extrauterine adenomyomas managed by laparoscopic excision: Three case reports with different theories of origin

B Nagy,

Papp,

Alaa Eldin

et al. 2023

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Introduction: We present three case reports of extrauterine adenomyoma (recto-vaginal/retro-cervical, broad ligament, abdominal). The common presenting symptoms in our patients were pelvic pain, dysmenorrhea, and deep dyspareunia. The cases were successfully treated with laparoscopic excision by a multidisciplinary team of doctors. One patient showed adenomyoma co-existing with endometriosis on histopathological examination of the tissue sample. Case Series: We present 3 cases of extra uterine adenomyomas in 3 different sites, each case representing a different theory of origin and all cases managed laparoscopically with successful outcome without any complications. First case represent the implantation theory following antecedent myomectomy. Second case represents origin of adenomyoma as direct extension from the uterus with background of severe diffuse adenomyosis. Third case represents origin from Müllerian remnants in the recto-vaginal septum with no adenomyosis or obliteration of the pouch Douglas. Conclusion: We propose the theory that adenomyoma which is a form of adenomyosis should be regarded as a form of deep endometriosis involving the uterus rather than a separate entity. We believe that multidisciplinary laparoscopic treatment is the way forward for accurate diagnosis and treatment of adenomyosis in patients requiring to preserve fertility. Future research needs to focus on studying endometriosis behavior and recurrence according to the tissue host to understand the disease and tailor the management according to patient symptoms.

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“…Different from endometrium adenocarcinoma in stage IB, which invades into deep myometrium from the eutopic endometrium, EAAFA arises from the adenomyotic epithelium within deep myometrium without invasion to surrounding tissues. However, further accumulation of the cases and molecular investigation are needed (17).…”

Section: Treatment and Prognosismentioning

confidence: 99%

Endometrioid adenocarcinoma arising from adenomyosis: two case reports and a literature review

et al. 2023

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BackgroundEndometrioid adenocarcinoma is usually diagnosed by endometrial curettage with a positive rate of 94%, while a hysteroscopic examination can increase the positive rate. Differently, endometrioid adenocarcinoma arising from adenomyosis (EAAFA) is always misdiagnosed, even after endometrial curettage or hysteroscopy. EAAFA is rarely reported.Case descriptionWe reported two cases of EAAFA with long-term follow-ups of 9–10 years. The two cases were misdiagnosed even if endometrial curettage or hysteroscopy was performed. One case complained of postmenopausal vaginal bleeding with elevated CA199, and she was diagnosed by fast-frozen pathology during hysterectomy, followed by bilateral salpingo-oophorectomy and pelvic lymphadenectomy. In another case, a premenopausal woman with acquired progressive dysmenorrhea was diagnosed as EAAFA by the histopathological result after a transvaginal hysterectomy and had to undergo reoperation. The FIGO stage was IB in both cases. Chemotherapy or radiotherapy was performed after the operation. Patients were followed up for 9–10 years, with no metastasis or recurrence being observed.ConclusionThe diagnosis of EAAFA is always delayed because of tumor-free eutopic endometrium and negative results of the endometrial curettage or hysteroscopy examination. Fast-frozen pathology of the whole uterus helps diagnose EAAFA precisely and avoids reoperation. Adenocarcinoma foci of EAAFA usually involve the myometrium deeply. A better prognosis of EAAFA should be expected due to good differentiation and negative lymphovascular space invasion.

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Adenomyosis as a Risk Factor for Myometrial or Endometrial Neoplasms—Review

Cited by 12 publications

References 55 publications

Clinical efficacy of a novel method of fertility-preserving adenomyomectomy in infertile women with diffuse adenomyosis

Clinical efficacy of a novel method of fertility-preserving adenomyomectomy in infertile women with diffuse adenomyosis

Extrauterine adenomyomas managed by laparoscopic excision: Three case reports with different theories of origin

Endometrioid adenocarcinoma arising from adenomyosis: two case reports and a literature review

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