Adenomyoma

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Adenomyoma
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Adenomyoma is a tumor (-oma) including components derived from glands (adeno-) and muscle (-my-). [1] It is a type of complex and mixed tumor, and several variants have been described in the medical literature. Uterine adenomyoma, the localized form of uterine adenomyosis, is a tumor composed of endometrial gland tissue and smooth muscle in the myometrium. [2] 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. [3] Gallbladder adenomyoma, the localized form of adenomyomatosis, is a polypoid tumor in the gallbladder composed of hyperplastic mucosal epithelium and muscularis propria. [4] [5] [6]

Contents

Classification

High magnification micrograph of uterine adenomyoma. Uterine adenomyosis -- very high mag.jpg
High magnification micrograph of uterine adenomyoma.

Uterine Adenomyoma

Uterine adenomyoma is the focal form of uterine adenomyosis. Adenomyosis most commonly presents with numerous small collections of endometrial glands and stroma spread diffusely throughout the myometrium, intermixed with the myometrial smooth muscle. 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 in the form of a polyp. [2]

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, uterine ligaments, and space surrounding the rectum. [3] Several cases have been located outside of the pelvis, such as in the liver, appendix, upper abdomen, and mesentery of the small bowel. There have also been patients with adenomyomas found at multiple locations in the body. [3]

Gallbladder Adenomyoma

Gallbladder adenomyomatosis is a benign disease of the gallbladder characterized by hyperplasia of the mucosal epithelium and smooth muscle cells inside the muscularis propria. [4] [5] [6] The excessive proliferation of epithelial cells causes the mucosa to invaginate into the muscular layer lining the gallbladder wall, resulting in characteristic diverticula known as Rokitansky-Aschoff sinuses. These sinuses may be filled with biliary sludge, cholesterol crystals, or gallstones. [4] [5] [6]

There are three morphologic variants described in the literature – diffuse, segmental, and localized. [5] [6] Diffuse, also known as generalized, adenomyomatosis has a widespread distribution of hyperplastic changes and thickening across the gallbladder wall. [5] [6] 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, that protrudes into the lumen of the gallbladder in the form of a polyp. [5] [6] The segmental form is characterized by its annular (ring-shaped) distribution of adenomyomatosis in the body of the gallbladder, often giving it an hourglass-like appearance. [5] [6]

Signs and symptoms

Uterine Adenomyoma

The clinical features of uterine adenomyosis vary widely and may include dysmenorrhea, pelvic pain, menorrhagia, and/or infertility, with about one in three affected women remaining asymptomatic. [2] Women with uterine adenomyomas (focal adenomyosis) more commonly have co-existing endometriosis 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. [2]

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. [3] 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. [3]

Gallbladder Adenomyoma

Most patients with adenomyomatosis are asymptomatic. [4] [5] [6] 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. [5] 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. [5] Other symptoms are often related to frequently co-occurring gallbladder diseases such as gallstones, cholecystitis, and choledocholithiasis. These may present with fever, pain, jaundice, or other symptoms. [5]

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. [2] Based on differences in the proteins 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. [2]

Extrauterine Adenomyoma

No exact risk factors have been described for adenomyomas that develop outside the uterus. [3] A history of prolonged hormone therapy is reported in two cases of patients diagnosed with an extrauterine adenomyoma, including estrogen 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. [3]

Several theories have been hypothesized to explain the pathogenesis. One theory describes extrauterine adenomyomas resulting from an error in Müllerian duct fusion during embryonic development, resulting in an abnormal uterus containing a horn-like structure. [3] 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 of these anatomic structures. [3]

Another theory suggests that extrauterine adenomyomas may result from smooth muscle metaplasia 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. [3]

Gallbladder Adenomyoma

The specific cause of gallbladder adenomyomatosis remains unclear. [4] [5] [6] Some of the risk factors for gallstone formation have also been reported in patients with adenomyomatosis such as hemolytic disease, congenital biliary abnormalities, obesity, and inflammatory bowel disease, but whether these are also risk factors for adenomyomatosis requires further investigation. [6]

The disease is currently thought to be a degenerative process and unlikely to be the result of congenital malformation. [5] [6] 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. [5] [6]

Diagnosis

Uterine Adenomyoma

Histopathology of uterine adenomyosis. H&E stain. Uterine adenomyosis -- intermed mag.jpg
Histopathology of uterine adenomyosis. H&E stain.

The most common diagnostic imaging modalities for uterine adenomyosis include transvaginal ultrasonography (TVS) and magnetic resonance imaging (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. [2]

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. [2] MRI is highly effective at distinguishing between uterine adenomyomas and leiomyomas. [3]

Extrauterine Adenomyoma

Adenomyoma of the ovary. Smooth muscle actin immunostain. Adenomyoma of the Ovary (Smooth Muscle Actin Immunostain) (4974731463).jpg
Adenomyoma of the ovary. Smooth muscle actin immunostain.

The most common imaging techniques include ultrasound, computed tomography (CT), and MRI. Intravenous pyelography (IVP) has also been used in some cases to assess for possible congenital anomalies of the kidneys. [3] 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 analysis. [3]

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. [3]

Gallbladder Adenomyoma

Rokitansky-Aschoff Sinus, Gallbladder Adenomyomatosis Rokitansky-Aschoff Sinus, Gallbladder (3704042567).jpg
Rokitansky-Aschoff Sinus, Gallbladder Adenomyomatosis

Adenomyomatosis is frequently associated with gallstones and is often diagnosed incidentally, either from a cholecystectomy specimen or autopsy. [4] [5] [6] No serologic test exists to specify adenomyomatosis and laboratory studies are often normal. Co-existing diseases like cholecystitis may result in abnormal test results, such as elevated levels of white blood cells (leukocytosis), liver enzymes (transaminitis), or bilirubin (hyperbilirubinemia). [5]

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. [4] [5] [6] The most characteristic features seen on ultrasound are the Rokitansky-Aschoff sinuses, which present either as echogenic foci when filled with biliary sludge/gallstones or anechogenic foci when filled with normal bile. [4] [5] [6] 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). [4] [5] [6] Ultrasound can also distinguish between diffuse, segmental, and localized variants of adenomyomatosis based on morphology. [5] [6]

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. [4] [5] [6] 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 cystic spaces that align in a curvilinear fashion along the gallbladder wall in a pattern described as the ”pearl necklace sign”. [4] [5] [6]

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. [2] Medical treatments include nonsteroidal anti-inflammatory drugs (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. [2]

A variety of effective procedures are also available if medical therapy is unsuccessful. These include minimally invasive procedures like high-intensity focused ultrasound or uterine artery embolization and more invasive options such as endometrial ablation or hysterectomy. [2] 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. [2]

Adenomyoma of the ovary. Surgical specimen. Adenomyoma of Ovary (gross) (4975345020).jpg
Adenomyoma of the ovary. Surgical specimen.

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 a common choice for pelvic adenomyomas. [3] Hormone therapy has also been combined with surgery in several cases, such as gonadotropin releasing hormone agonists, progesterone, and aromatase inhibitors. [3]

Gallbladder Adenomyoma

Cholecystectomy, or surgical removal of the gallbladder, is the recommended treatment for patients with symptomatic adenomyomatosis. [4] [5] [6] 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. [4] [5] [6] 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. [5]

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. [2] [7]

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. [2] [7] 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. [2] [7]

Patients with adenomyosis have been found to have lower successful live birth rates and higher rates of miscarriage following in vitro fertilization (IVF) compared to those without adenomyosis. [2] [7] 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 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. [2] 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. [2] [7]

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. [8]

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 growths in the ovaries or uterus. [3]

Gallbladder Adenomyoma

Though itself considered a benign disease, the potential role of gallbladder adenomyomatosis in the carcinogenesis of gallbladder cancer remains unclear. [4] [5] [6] Previous studies have highlighted several cases of adenomyomatosis associated with gallbladder malignancy, with a particularly strong correlation between segmental adenomyomatosis and gallbladder carcinoma. [5] 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. [2] The demographic with the highest incidence in this retrospective cohort study were black women and women aged 40–45 years, with women in their early 40s the most likely to be symptomatic. [2]

Extrauterine Adenomyoma

Much less common than the intrauterine counterpart, one review found 34 cases of extrauterine adenomyoma described in the literature. [3] The ages of affected women at diagnosis have had a wide range from 17 to 70 years. [3]

Gallbladder Adenomyoma

Adenomyomatosis is discovered in approximately 5% of cholecystectomy specimens. [4] [5] [6] Most patients who are diagnosed are in their 50s or older, [4] [5] [6] with a rare few cases found in children. [5] [6]

See also

Related Research Articles

<span class="mw-page-title-main">Endometrium</span> Inner mucous membrane of the mammalian uterus

The endometrium is the inner epithelial layer, along with its mucous membrane, of the mammalian uterus. It has a basal layer and a functional layer: the basal layer contains stem cells which regenerate the functional layer. The functional layer thickens and then is shed during menstruation in humans and some other mammals, including apes, Old World monkeys, some species of bat, the elephant shrew and the Cairo spiny mouse. In most other mammals, the endometrium is reabsorbed in the estrous cycle. During pregnancy, the glands and blood vessels in the endometrium further increase in size and number. Vascular spaces fuse and become interconnected, forming the placenta, which supplies oxygen and nutrition to the embryo and fetus. The speculated presence of an endometrial microbiota has been argued against.

<span class="mw-page-title-main">Uterus</span> Female sex organ in mammals

The uterus 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 embryos until birth. The uterus is a hormone-responsive sex organ that contains glands in its lining that secrete uterine milk for embryonic nourishment.

<span class="mw-page-title-main">Endometriosis</span> Disease of the female reproductive system

Endometriosis is a disease of the female reproductive system in which cells similar to those in the endometrium, the layer of tissue that normally covers the inside of the uterus, grow outside the uterus. Lesions can be found on ovaries, fallopian tubes, tissue around the uterus and ovaries (peritoneum), intestines, bladder, and diaphragm; it may also occur in other parts of the body. Some symptoms include pelvic pain, heavy periods, pain with bowel movements, painful urination, pain during sexual intercourse and infertility. Nearly half of those affected have chronic pelvic pain, while in 70% pain occurs during menstruation. Infertility occurs in up to half of affected individuals. About 25% of individuals have no symptoms and 85% of those seen with infertility in a tertiary center have no pain. Endometriosis can have both social and psychological effects.

<span class="mw-page-title-main">Uterine cancer</span> Medical condition

Uterine cancer, also known as womb cancer, includes two types of cancer that develop from the tissues of the uterus. Endometrial cancer forms from the lining of the uterus, and uterine sarcoma forms from the muscles or support tissue of the uterus. Endometrial cancer accounts for approximately 90% of all uterine cancers in the United States. Symptoms of endometrial cancer include changes in vaginal bleeding or pain in the pelvis. Symptoms of uterine sarcoma include unusual vaginal bleeding or a mass in the vagina.

<span class="mw-page-title-main">Endometrial cancer</span> Uterine cancer that is located in tissues lining the uterus

Endometrial cancer is a cancer that arises from the endometrium. It is the result of the abnormal growth of cells that have the ability to invade or spread to other parts of the body. The first sign is most often vaginal bleeding not associated with a menstrual period. Other symptoms include pain with urination, pain during sexual intercourse, or pelvic pain. Endometrial cancer occurs most commonly after menopause.

Abnormal uterine bleeding (AUB), also known as (AVB) or as atypical vaginal bleeding, is vaginal bleeding from the uterus that is abnormally frequent, lasts excessively long, is heavier than normal, or is irregular. The term dysfunctional uterine bleeding was used when no underlying cause was present. Vaginal bleeding during pregnancy is excluded. Iron deficiency anemia may occur and quality of life may be negatively affected.

<span class="mw-page-title-main">Adenomyosis</span> Extension of endometrial tissue into the myometrium

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. As well as being misplaced in patients with this condition, endometrial tissue is completely functional. The tissue thickens, sheds and bleeds during every menstrual cycle.

<span class="mw-page-title-main">Vaginal bleeding</span> Medical condition

Vaginal bleeding is any expulsion of blood from the vagina. This bleeding may originate from the uterus, vaginal wall, or cervix. Generally, it is either part of a normal menstrual cycle or is caused by hormonal or other problems of the reproductive system, such as abnormal uterine bleeding.

<span class="mw-page-title-main">Uterine fibroid</span> Medical condition with benign tumors of uterus

Uterine fibroids, also known as uterine leiomyomas or fibroids, are benign smooth muscle tumors of the uterus. Most women with fibroids have no symptoms while others may have painful or heavy periods. If large enough, they may push on the bladder, causing a frequent need to urinate. They may also cause pain during penetrative sex or lower back pain. A woman can have one uterine fibroid or many. Occasionally, fibroids may make it difficult to become pregnant, although this is uncommon.

The uterine sarcomas form a group of malignant tumors that arises from the smooth muscle or connective tissue of the uterus.

<span class="mw-page-title-main">Catamenial pneumothorax</span> Medical condition

Catamenial pneumothorax is a spontaneous pneumothorax that recurs during menstruation, within 72 hours before or after the onset of a cycle. It usually involves the right side of the chest and right lung, and is associated with thoracic endometriosis. A third to a half of patients have pelvic endometriosis as well. Despite this association, CP is still considered to be misunderstood as is endometriosis considered to be underdiagnosed. The lack of a clear cause means that diagnosis and treatment is difficult. The disease is believed to be largely undiagnosed or misdiagnosed, leaving the true frequency unknown in the general population.

<span class="mw-page-title-main">Mixed Müllerian tumor</span> Medical condition

A malignant mixed Müllerian tumor, also known as malignant mixed mesodermal tumor (MMMT) is a cancer found in the uterus, the ovaries, the fallopian tubes and other parts of the body that contains both carcinomatous and sarcomatous components. It is divided into two types, homologous and a heterologous type. MMMT account for between two and five percent of all tumors derived from the body of the uterus, and are found predominantly in postmenopausal women with an average age of 66 years. Risk factors are similar to those of adenocarcinomas and include obesity, exogenous estrogen therapies, and nulliparity. Less well-understood but potential risk factors include tamoxifen therapy and pelvic irradiation.

Ovarian diseases refer to diseases or disorders of the ovary.

<span class="mw-page-title-main">Uterine serous carcinoma</span> Medical condition

Uterine serous carcinoma is a malignant form of serous tumor that originates in the uterus. It is an uncommon form of endometrial cancer that typically arises in postmenopausal women. It is typically diagnosed on endometrial biopsy, prompted by post-menopausal bleeding.

Uterine clear-cell carcinoma (CC) is a rare form of endometrial cancer with distinct morphological features on pathology; it is aggressive and has high recurrence rate. Like uterine papillary serous carcinoma CC does not develop from endometrial hyperplasia and is not hormone sensitive, rather it arises from an atrophic endometrium. Such lesions belong to the type II endometrial cancers.

Genital leiomyomas are leiomyomas that originate in the dartos muscles, or smooth muscles, of the genitalia, areola, and nipple. They are a subtype of cutaneous leiomyomas that affect smooth muscle found in the scrotum, labia, or nipple. They are benign tumors, but may cause pain and discomfort to patients. Genital leiomyoma can be symptomatic or asymptomatic and is dependent on the type of leiomyoma. In most cases, pain in the affected area or region is most common. For vaginal leiomyoma, vaginal bleeding and pain may occur. Uterine leiomyoma may exhibit pain in the area as well as painful bowel movement and/or sexual intercourse. Nipple pain, enlargement, and tenderness can be a symptom of nipple-areolar leiomyomas. Genital leiomyomas can be caused by multiple factors, one can be genetic mutations that affect hormones such as estrogen and progesterone. Moreover, risk factors to the development of genital leiomyomas include age, race, and gender. Ultrasound and imaging procedures are used to diagnose genital leiomyomas, while surgically removing the tumor is the most common treatment of these diseases. Case studies for nipple areolar, scrotal, and uterine leiomyoma were used, since there were not enough secondary resources to provide more evidence.

<span class="mw-page-title-main">Interstitial pregnancy</span> Medical condition

An interstitial pregnancy is a uterine but ectopic pregnancy; the pregnancy is located outside the uterine cavity in that part of the fallopian tube that penetrates the muscular layer of the uterus. The term cornual pregnancy is sometimes used as a synonym, but remains ambiguous as it is also applied to indicate the presence of a pregnancy located within the cavity in one of the two upper "horns" of a bicornuate uterus. Interstitial pregnancies have a higher mortality than ectopics in general.

The uterus-like mass (ULM) is a tumorlike anatomical entity originally described in the ovary in 1981 and thereafter reported in several locations of the pelvis and abdominal cavity including broad ligament, greater omentum, cervix, small intestine, mesentery and conus medullaris. Basically, it is represented by a miniature uterus comprising a smooth muscle wall lined by endometrium thus outlining a uterus anatomical structure. Some of the reported cases have been associated to urinary tract and internal genitalia malformations whereas others appeared as a solitary finding. The term endomyometriosis has also been applied to this lesion.

<span class="mw-page-title-main">Adenomyomatosis</span> Medical condition

Adenomyomatosis is a benign condition characterized by hyperplastic changes of unknown cause involving the wall of the gallbladder. Adenomyomatosis is caused by an overgrowth of the mucosa, thickening of the muscular wall, and formation of intramural diverticula or sinus tracts termed Rokitansky–Aschoff sinuses, also called entrapped epithelial crypts.

Thoracic endometriosis is a rare form of endometriosis where endometrial-like tissue is found in the lung parenchyma and/or the pleura. It can be classified as either pulmonary, or pleural, respectively. Endometriosis is characterized by the presence of tissue similar to the lining of the uterus forming abnormal growths elsewhere in the body. Usually these growths are found in the pelvis, between the rectum and the uterus, the ligaments of the pelvis, the bladder, the ovaries, and the sigmoid colon. The cause is not known. The most common symptom of thoracic endometriosis is chest pain occurring right before or during menstruation. Diagnosis is based on clinical history and examination, augmented with X-ray, CT scan, and magnetic resonance imaging of the chest. Treatment options include surgery and hormones.

References

  1. " adenomyoma " at Dorland's Medical Dictionary
  2. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Latif, Sania; Saridogan, Ertan (2022-09-25). "Uterine adenomyoma—what we know, and what we don't know: a narrative review". Gynecology and Pelvic Medicine. 5: 25. doi: 10.21037/gpm-21-50 . ISSN   2617-4499. S2CID   250290892.
  3. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Paul, P.G.; Gulati, Gunjan; Shintre, Hemant; Mannur, Sumina; Paul, George; Mehta, Santwan (September 2018). "Extrauterine adenomyoma: a review of the literature". European Journal of Obstetrics & Gynecology and Reproductive Biology. 228: 130–136. doi:10.1016/j.ejogrb.2018.06.021. PMID   29940416. S2CID   49476487.
  4. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Joshi, Jonathan K.; Kirk, Lindsey (2022), "Adenomyomatosis", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   29489201 , retrieved 2023-01-28
  5. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Pellino, Gianluca; Sciaudone, Guido; Candilio, Giuseppe; Perna, Giuseppe; Santoriello, Antonio; Canonico, Silvestro; Selvaggi, Francesco (April 2013). "Stepwise approach and surgery for gallbladder adenomyomatosis: a mini-review". Hepatobiliary & Pancreatic Diseases International. 12 (2): 136–142. doi:10.1016/s1499-3872(13)60022-3. ISSN   1499-3872. PMID   23558066.
  6. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Parolini, Filippo; Indolfi, Giuseppe; Magne, Miguel Garcia; Salemme, Marianna; Cheli, Maurizio; Boroni, Giovanni; Alberti, Daniele (2016-05-08). "Adenomyomatosis of the gallbladder in childhood: A systematic review of the literature and an additional case report". World Journal of Clinical Pediatrics. 5 (2): 223–227. doi: 10.5409/wjcp.v5.i2.223 . ISSN   2219-2808. PMC   4857236 . PMID   27170933.
  7. 1 2 3 4 5 Cozzolino, Mauro; Tartaglia, Silvio; Pellegrini, Livia; Troiano, Gianmarco; Rizzo, Giuseppe; Petraglia, Felice (November 2022). "The Effect of Uterine Adenomyosis on IVF Outcomes: a Systematic Review and Meta-analysis". Reproductive Sciences. 29 (11): 3177–3193. doi:10.1007/s43032-021-00818-6. ISSN   1933-7191. PMID   34981458. S2CID   245654611.
  8. Takeuchi H, Kitade M, Kikuchi I, Kumakiri J, Kuroda K, Jinushi M (June 2009). "Diagnosis, laparoscopic management, and histopathologic findings of juvenile cystic adenomyoma: a review of nine cases". Fertil. Steril. 94 (3): 862–868. doi:10.1016/j.fertnstert.2009.05.010. PMID   19539912.