Goubaa Mohamed MD Djerba Tunisia

English Français
--- Arabic
This is a 43-year-old female with history of infertility. The patient also complained constipation and increasing abdominal girth. An ultrasound study was performed. Voici le cas d'une patiente de 43 ans avec une histoire de stérilité primaire. Elle se plaint de constipation et d'une distension abdominale. Un examen échographique a été pratiquée.


Transvaginal sonography Echographie endovaginale

definitive treatment is hysterectomy : the removed mass : En Chirurgie: hystérectomie et ablation d'un gros utérus en boule.

The follow-up study : 2 years later : only the cervix Contrôle : 2 ans plus tard

Click on the image below
Cliquez sur les images en bas













2 years later
2 ans plus tard

A15-cm solid mass is seen above the bladder. The mass abuts the uterine fundus (Scan 1) but is not separate from the uterus (Scan 2 : transvaginal scanning). Here, It is difficult to tell the difference between adenomyosis and fibroids. Adenomyosis were confirmed by pathologic examination.
Abdominal hysterectomy were performed. The postoperative period of the patient was uneventful.

Extreme enlargement of the uterus is possible due to adenomyosis alone (1).

Masse solide de 15 cm est visible au dessus de la vessie (cliché 1). la masse est au dépend de l'utérus et c'est visible par échographie endovaginale (cliché 2). Ici, il est difficile de différencier, ici, entre une fibrome et une adénomyose utérine. L'étude anatomopathologique confirme l'adénomyose.
Conclusion :
l'élargissement important de l'utérus peut avoir comme unique cause l'adénomyose.
Adenomyosis Adénomyose Utérine _______________


Click Here

Cliquez ici


1: Gynecol Obstet Invest. 2004 Aug 24;58(4):216-218. A Case of Adenomyosis per se with a Uterine Weight of 475 g. Harmanli OH, Shen T, Zhu S, Chatwani AJ. Department of Obstetrics and Gynecology, Temple University School of Medicine, Philadelphia, Pa., USA.
2: Clin Radiol. 2004 Jun;59(6):520-6. Uterine artery embolization for adenomyosis without fibroids. Kim MD, Won JW, Lee DY, Ahn CS. Diagnostic Radiology, Bundang CHA General Hospital, Pochon CHA University, 351 Yatap-dong, Bundang-gu, Sungnam-si, Kyonggi-do, Sungnam, South Korea. mdkim@cha.ac.kr
3: Ultrasound Obstet Gynecol. 2002 Dec;20(6):605-11. Comment in: Ultrasound Obstet Gynecol. 2003 Jun;21(6):626-7. Limitations of transvaginal sonography for the diagnosis of adenomyosis, with histopathological correlation. Bazot M, Darai E, Rouger J, Detchev R, Cortez A, Uzan S. Department of Radiology, Hopital Tenon, Paris, France. marc.bazot@tnn.ap-hop-paris.fr
4: AJR Am J Roentgenol. 2002 Aug;179(2):379-83. Sonographic findings in patients with adenomyosis: can sonography assist in predicting extent of disease? Hulka CA, Hall DA, McCarthy K, Simeone J. Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA.
5: Tunis Med. 2001 Aug-Sep;79(8-9):447-51. [Adenomyosis: analysis of 35 cases] Ben Aissia N, Berriri H, Gara F. Service de gynecologie-obstetrique, CHU Mongi Slim La Marsa.
6: Hum Reprod. 2001 Nov;16(11):2427-33. Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Bazot M, Cortez A, Darai E, Rouger J, Chopier J, Antoine JM, Uzan S. Department of Radiology, Hopital Tenon, 4 rue de la Chine, 75020, France. marc.bazot@tnn.ap-hop-paris.fr
7: Fertil Steril. 2001 Sep;76(3):588-94. Magnetic resonance imaging and transvaginal ultrasonography for the diagnosis of adenomyosis. Dueholm M, Lundorf E, Hansen ES, Sorensen JS, Ledertoug S, Olesen F. Department of Gynecology and Obstetrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark. hjorth@dadlnet.dk
8: J Ultrasound Med. 2000 Aug;19(8):529-34; quiz 535-6. Adenomyosis: sonographic findings and diagnostic accuracy. Bromley B, Shipp TD, Benacerraf B. Department of Obstetrics and Gynecology, Massachusetts General Hospital, and Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
9: Radiology. 2000 Jun;215(3):783-90. Adenomyosis: US features with histologic correlation in an in-vitro study. Atri M, Reinhold C, Mehio AR, Chapman WB, Bret PM. Department of Radiology, McGill University, Montreal General Hospital, Quebec, Canada. mostafa_atri@pmh.toronto.on.ca
10: Hum Reprod Update. 1998 Jul-Aug;4(4):350-9. The response of adenomyosis to endometrial ablation/resection. McCausland V, McCausland A. Department of Obstetrics and Gynecology, University of Southern California, Los Angeles County Medical Center, Women and Children's Hospital, Los Angeles, 90033, USA.
11: Hum Reprod Update. 1998 Jul-Aug;4(4):323-36. Surgical and medical treatment of adenomyosis. Wood C. Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia.
12: Hum Reprod. 1998 Oct;13(1O):2884-7. Transvaginal ultrasonography versus uterine needle biopsy in the diagnosis of diffuse adenomyosis. Vercellini P, Cortesi I, De Giorgi O, Merlo D, Carinelli SG, Crosignani PG. Clinica Ostetrica e Ginecologica Luigi Mangiagalli, University of Milano, Italy.
13: Radiology. 1996 Apr;199(1):151-8. Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. Reinhold C, McCarthy S, Bret PM, Mehio A, Atri M, Zakarian R, Glaude Y, Liang L, Seymour RJ. Department of Diagnostic Radiology, Montreal General Hospital, McGill University School of Medicine, Quebec, Canada.
14: Radiology. 1995 Dec;197(3):609- 14. Diffuse uterine adenomyosis: morphologic criteria and diagnostic accuracy of endovaginal sonography. Reinhold C, Atri M, Mehio A, Zakarian R, Aldis AE, Bret PM. Department of Diagnostic Radiology, Montreal General Hospital, Quebec, Canada.
15: Akush Ginekol (Mosk). 1994;(2):40-3. [A clinico-morphological comparison of the ultrasonic criteria of adenomyosis] [Article in Russian] Damirov MM, Bakuleva LP, Shabanov AM, Sliusar' NN.
16: Fertil Steril. 1992 Jul;58(1):94-7. Comment in: Fertil Steril. 1993 Feb;59(2):479. Transvaginal ultrasonography in the diagnosis of diffuse adenomyosis. Fedele L, Bianchi S, Dorta M, Arcaini L, Zanotti F, Carinelli S. Istituto Ostetrico-Ginecologico L. Mangiagalli, Universita di Milano, Italy.
17: J Ultrasound Med. 1987 Jul;6(7):345-9. Uterine adenomyosis. A difficult sonographic diagnosis. Siedler D, Laing FC, Jeffrey RB Jr, Wing VW.
18: AJR Am J Roentgenol. 1987 Apr;148(4):765-6. Sonographic findings in adenomyosis of the uterus. Bohlman ME, Ensor RE, Sanders RC.
19: Nippon Sanka Fujinka Gakkai Zasshi. 1986 Nov;38(11):2073-7. Ultrasonography for the diagnosis of adenomyosis. Murao F, Hata K, Shin K, Hata T, Yoshino K, Yamamoto K, Takahashi K, Kitao M.
20: Diagn Gynecol Obstet. 1982 Summer;4(2):105-6. The preoperative diagnosis of adenomyosis. Weseley AC.