Adenomyotic cyst of the uterus associated with pelvic pain: A case report

Year 2014, , 100 - 102, 01.03.2014

Berna Dilbaz Özlem Şengül Tuba Zengin Hatice Dilek Bülbül Leyla Mollamahmutoğlu

https://doi.org/10.5799/ahinjs.01.2014.01.0368

Abstract

Adenomyotic cysts of the uterus are extremely rare and this case report is to document an adenomyotic cyst of the uterus associated with pelvic pain. A 27-year old nulliparous patient admitted to the hospital with the complaint of dysmenorrhea, dyspareunia and pain in the right pelvic region for the last 3 months. Transvaginal ultrasonographic examination revealed a 50 × 36 mm intramural cystic lesion on the right region of the corpus uteri. Hysteroscopic examination showed that it did not deteriorate the endometrial cavity. During laparatomy dissection of the uterine wall revealed 5 cm cystic lesion that was excised circumferentially protecting the surrounding myometrial tissue. The definitive pathology report came out as adenomyotic tissue. Imaging techniques are critical in differential diagnosis of adenomyotic cysts and to choose the appropriate intervention. Medical therapy or surgical intervention like excision of the cyst or hysterectomy may be the choices of treatment. J Clin Exp Invest 2014; 5 (1): 100-102

Keywords

Adenomyotic cyst, pelvic pain, laparatomy..

Pelvik ağrı ile ilişkili uterusun adenomyotik kisti: Olgu sunumu

Abstract

Uterusun adenomyotik kistleri çok nadirdir ve bu vaka sunumunda pelvik ağrı ile ilişkili uterusun adenomyotik kisti sunulmuştur. 27 yaşındaki nulligravid hasta dismenore, disparenü ve son 3 aydır devam eden sağ pelvik ağrı şikayeti ile hastaneye başvurmuştur. Transvajinal ultrasonografide uterus korpusunun sağında 50 × 36 mm intramural kistik lezyon saptandı. Histeroskopik incelemede lezyonun endometrial kaviteyi etkilemediği izlendi. Laparatomi sırasında çevre myometrial doku korunarak 5 cm boyutundaki kist çepeçevre diseke edilerek çıkarıldı. Patoloji sonucu adenomyotik doku olarak geldi. Görüntüleme yöntemleri adenomyotik kistlerin ayırıcı tanısında ve uygun tedavinin seçiminde önemlidir. Medikal tedavi veya kistin eksizyonu ya da histerektomi gibi cerrahi yaklaşımlar tedavi seçenekleri olabilir.

Keywords

Adenomyotik kist, pelvik ağrı, laparatomi.

References

• Ferenczy A. Pathophysiology of adenomyosis. Hum Reprod Update 1998; 4:312.
• English DP, Verma U, Pearson JM. Uterine cyst as a cause of chronic pelvic pain: a case report. J Reprod Med. 2012;57:446-448.
• Ejeckam GC, Zeinab OA, Salman M, Bobeck HE. Giant adnomyotic cyst of the uterus. Br J Obstet Gynecol 1993;100:596–598.
• Kamio M, Taguchi S, Oki T, et al. Isolated adenomyotic cyst associated with severe dysmenorrhea. J Obstet Gynaecol Res 2007;33:388-391.
• Tamura M, Fukaya T, Takaya R, et al. Juvenile adeno- myotic cyst of the corpus uteri with dysmenorrhea. To- hoku J Exp Med 1996;178:339-344.
• Slezak P, Tillinger KG. The incidence and clinical im- portance of hysterographic evidence of cavities in the uterine wall. Radiology 1976;118:581-586.
• Koga K, Osuga Y, Hiroi H , et al. A case of giant cystic adenomyosis. Fertil Steril 2006; 85: 748–749.
• Evsen MS, Sak ME, Soydinç HE, et al. Adenomyoma- tous polyp causing acute urinary retention in a post- menopausal woman. J Clin Exp Invest 2011;2:312- 314.
• Tamai K, Togashi K, Ito T, et al. MR imaging findings of adenomyosis: correlation with histopathologic features and diagnostic pitfalls. Radiographics 2005;25:21–40.
• Giana M, Montella F, Surico D, et al. Large intramyo- metrial cystic adenomyosis: a hysteroscopic approach with bipolar resectoscope: case report. Eur J Gynae- col Oncol 2005;26:462-463.