An overview of adenomyosis and its surgical management

Adenomyosis has long been regarded as a close ‘cousin’ of endometriosis, although the two conditions behave quite differently. Adenomyosis is a relatively common gynecologic disorder, but has often been described as an elusive disease. Histologically, it is characterized by the extension of endometrial glands and stroma beneath the endometrial-myometrial interface to form nests deep within the myometrium. Subsequent myometrial hyperplasia around the adenomyotic foci is also characteristic. Rokitansky1 first described the condition in 1860, followed by further descriptions by von Recklinghausen in 1896.2 In 1908, Cullen3classified two histologic types:• ‘adenomyoma,’ a tumor-like isolated area of hypertrophic myometrium containing stroma and glandular elements of the endometrium• ‘diffuse adenomyoma,’ a distribution of both elements throughout widespread areas of the myometrium.