Clinical History:
- A 35 year-old woman complained of irregular periods and dysmenorrhea. The uterine corpus was thought to be diffusely enlarged on pelvic exam. A hysterectomy was performed. The uterus weighed 300 grams (normal: up to 225 grams). and the cut surface of the myometrium showed coarse trabeculations. The image is a section of the myometrium. Notice the multiple foci of endometrial-type glands within the smooth muscle. These glands are associated with endometrial-type stroma.
- What is the diagnosis?
This is an excellent example of what is termed adenomyosis. The abnormally-placed endometrial tissue induces myometrial smooth muscle hypertrophy, and, hence, gross uterine enlargement. The condition is associated with irregular menstrual cycles and dysmenorrhea.
- How is this process different from an invasive endometrial carcinoma?
In invasive endometrial adenocarcinoma, only the neoplastic
endometrial glands would be present in the myometrium.
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