Diffuse uterine adenomyosis

Case contributed by Ian Bickle


Menorrhragia and oligomenorrhea for 6 months. Clinician ultrasound reported as fibroid uterus for MRI.

Patient Data

Age: 40 years
Gender: Female

The uterus is markedly enlarged with the fundus at the L3-L4 disc space.

The body and fundus is diffusely enlarged due to ill defined thickening of the inner myometrium with multiple small T2 foci within. The junctional zone measures 4.5cm. No discrete mass.

Endometrial cavity normal. No distortion.

Case Discussion

Adenomyosis of the uterus is a relatively common, benign uterine pathology. It is thought by many to be on the spectrum of endometriosis, with ectopic endometrial tissue in the myometrium.

It may be diffuse, as illustrated in this fairly advanced case, or focal in nature.  It is one of several causes for an enlarged uterus.

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