Case Report And Literature Review Of Big Cystic Uterine Adenomyosis

Background and objectivesUterine adenomyosis is endometrium which grows into myometrium benignly leads to enlargement of the uterus, microscopically,in myometrium ectopic but nonnew-born endometrial glands and stroma were found,which arounds with hyperplasia and hypertrophy of womb smooth muscle. Most patients complained of menstrual quantity increased, severe dysmenorrhea or infertility, according to the pathological diagnosis,the patients of uterine adenomyosis whose age is almost from late 30s to early 50s, and hemorrhage and severe dysmenorrhea are the most common clinical symptoms in patients, the disease impacts serious influences on the physical and mental health of women.There are different types of uterine adenomyosis, but the cystic uterine adenomyosis is relatively rare, among them the bigger one whose diameter is greater than 3 cm is more rare.Through the analysis of big cystic cases of uterine adenomyosis, we can understand its clinical characteristics, combined with the clinical manifestation and imaging examination, in order to investigate the diagnosis and differential diagnosis of large uterine cystic adenomyosis, and further analyses the classification and pathogenesis of uterine adenomyosis.Materials and methodsIn 2014,two cases of big cystic uterine adenomyosis were diagnosed and treated by the Obstetrics and Gynecology Department of Qilu Hospital,we made analysis of the clinical data,with the clinical details and accessory checks, combining with the relevant medical literature, we made efforts to explore the pathological manifestation,pathogenesis,clinical manifestations,imaging characteristics,diagnosis and differential diagnosis of the disease,and made generalizations.ResultsAccording to clinical characteristics and imaging examinations,the preliminary diagnosis of the two cases were cystic uterine adenomyosis. After relevant inspection completed,we gave the patients laparoscopic surgery. We found chocolate liquid in both of the lesions,removed the cyst completely,pathology examination showed ectopic endometrium in the samples,diagnosed as uterine adenomyosis. We provided a GnRH-a treatment for 6 months postoperatively, through our follow-up visit,we found no recurrence.ConclusionsUterine adenomyosis always occurs in middle-aged women, but juvenile case without sexual life is rare in clinical, especially large cystic womb adenomyosis. We know that these big cystic uterine adenomyosis need to be identified with uterine malformation.Cystic uterine adenomyosis patients always have much more severe symptom of dysmenorrhea,so clinicians should improve the knowledge and understanding of the disease. Surgery is the preferred therapy of cystic uterine adenomyosis.