Anemic with menorrhagia. Ultrasound pelvis identified a large uterus with fibroids.
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Multiple uterine fibroids seen in a bulky uterus. Diffusely thickened posterior junctional zone showing multiple cystic areas suggestive of adenomyosis.
Ancillary findings include: left broad ligament fibroid, mild free fluid in pouch of Douglas; right ovarian clear cyst.
Adenomyosis is a typical culprit of long standing dysmemorrhea and menorrhagia commonly seen in multiparous women in the reproductive age group. Its diffuse indistinct nature differentiates it from fibroids. Both may occur in tandem as seen in this case.