Diffuse uterine adenomyosis

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Menometrorrhagia.

Patient Data

Age: 50 years
Gender: Female
mri

The uterus is diffusely enlarged with globular shape. Diffuse thickening of the junctional zone endometrium-myometrium up to 36 mm of intermediate signal on T1 and low signal on T2 with foci of high signal within, indicating menstrual hemorrhage into the ectopic endometrial tissues.

Normal appearance of the ovaries.

Spondylolisthesis at L5-S1 grade I with bilateral pars interarticularis defect.

Double midline hernias of the anterior abdominal wall: umbilical hernia of epiploic content and supraumbilical hernia of intestino-epiploic content.

Case Discussion

MRI features most consistent with diffuse uterine adenomyosis.

Diffuse uterine adenomyosis is the most common form of uterine adenomyosis and accounts for ~2/3rd of uterine adenomyosis.

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