Adenomyosis
Clinical story
A 52 years old woman with meno/metrorrhagia and an enlarged uterus. A leiomyoma was suspected and a supravaginal hysterectomy performed. Grossly, the uterus appeared diffusely enlarged, with a coarse myometrium with small brown dots or cysts in the inner part of the myometrium. No leiomyoma was seen.
The section is from the anterior wall.
Comments
The border between endometrium and myometrium is irregular , with deep extensions of endometrium into the myometrium. Some glands are dilated. There is no hyperplasia or atypia.
Learning goals
To recognize displaced endometrium within the uterine wall and understand its implications for disease and possibility of recurrence after endometrial ablations.