Juvenile cystic adenomyoma, a rare diagnostic challenge: Case Reports and literature review

Sushila Arya, Heather R. Burks
In: F&S Reports · 2021 · vol. 2(2) , pp. 166–171 · doi:10.1016/j.xfre.2021.02.002 · PMID:34278349 · PMC8267394 · W3131564948
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Abstract

OBJECTIVE: To report 2 very rare cases of young women who presented with severe dysmenorrhea and a large cystic lesion in the myometrium, which presented a diagnostic dilemma because they were confused with a Müllerian anomaly. DESIGN: Case reports and a literature review. SETTING: A university-based reproductive endocrinology and infertility clinic in the United States. PATIENTS: An 18- and a 16-year-old nulliparous girl presented with worsening of their longstanding pelvic pain, and imaging study results were suggestive of a Müllerian anomaly. INTERVENTIONS: Abdominal and pelvic computed tomography, transvaginal ultrasonography, pelvic magnetic resonance imaging, operative laparoscopy, and excision of a juvenile cystic adenomyoma (JCA). MAIN OUTCOME MEASURES: Resolution of the pelvic pain and restoration of normal uterine anatomy after appropriate intervention. RESULTS: Restoration of normal uterine anatomy, which was confirmed by 3-dimensional ultrasonography for case 1; however, case 2 still had a small remnant of JCA postoperatively. CONCLUSIONS: Clinical and radiologic examinations may not be useful in differentiating a Müllerian anomaly from other rare abnormalities like JCA. When in doubt, laparoscopy can assist in diagnosing and treating the condition.

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dysmenorrheainfertility

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