Adenomyosis-a rare cause of chronic lumbago in adolescents

Kavitha Yogini, Varsha Maran
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2023 · vol. 13(1) , pp. 185–188 · doi:10.18203/2320-1770.ijrcog20234101 · W4390430091
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⚙ AI-generated summary by claude@2026-07, 2026-07-08 ⓘ

This paper describes adenomyosis, a rare cause of chronic lumbago in adolescents, and highlights diagnostic challenges and treatment options like dienogest.

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This paper reviews adenomyosis as a rare cause of chronic lumbago in adolescents, noting that adolescent cases are uncommon and that in extremely young individuals classic diagnostic indicators may be absent on clinical exam, sonography, or radiology. It describes adenomyosis histologically as ectopic endometrial glands and stroma at least 2.5 mm below the endomyometrial junction with hypertrophic and hyperplastic surrounding myometrium, and states that while cystic adenomyosis is more common in younger patients, diffuse adenomyosis should be considered in refractory pelvic pain. The paper reports that combining ultrasound and MRI improves diagnostic sensitivity and that dienogest (“millennial molecule”), established for endometriosis, is also presented as a first-line drug option for adenomyosis, especially diffuse forms. This paper is centrally about adenomyosis — it frames adolescent adenomyosis as a rare explanation for chronic lumbago and discusses diagnostic and treatment considerations.

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Abstract

Adenomyosis is a benign condition of the uterus that was previously diagnosed through histology after hysterectomy. Specifically, ectopic endometrial glands and stroma were seen at a minimum depth of 2.5 mm below the Endo myometrial junction, along with hypertrophic and hyperplastic surrounding myometrium. Adolescent adenomyosis is not known to occur frequently. Furthermore, in extremely young individuals, the classic diagnostic indicators of adenomyosis may not be present during clinical, sonographic, or radiologic testing. Although cystic form of adenomyosis is more common in the younger age group, diffuse adenomyosis should always be considered in refractory pelvic pain. Ultrasound and MRI done together has improved sensitivity for the diagnosis of adenomyosis. Dienogest, the millennial molecule, not only serves its purpose in endometriosis but also one of the first line drugs in the management of adenomyosis, particularly the diffuse forms.
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Adenomyosis-a rare cause of chronic lumbago in adolescents DOI: https://doi.org/10.18203/2320-1770.ijrcog20234101Keywords: Adenomyosis, Millennial molecule, Endo myometrial junctionAbstract Adenomyosis is a benign condition of the uterus that was previously diagnosed through histology after hysterectomy. Specifically, ectopic endometrial glands and stroma were seen at a minimum depth of 2.5 mm below the Endo myometrial junction, along with hypertrophic and hyperplastic surrounding myometrium. Adolescent adenomyosis is not known to occur frequently. Furthermore, in extremely young individuals, the classic diagnostic indicators of adenomyosis may not be present during clinical, sonographic, or radiologic testing. Although cystic form of adenomyosis is more common in the younger age group, diffuse adenomyosis should always be considered in refractory pelvic pain. Ultrasound and MRI done together has improved sensitivity for the diagnosis of adenomyosis. Dienogest, the millennial molecule, not only serves its purpose in endometriosis but also one of the first line drugs in the management of adenomyosis, particularly the diffuse forms. Metrics References Moawad G, Fruscalzo A, Youssef Y, Kheil M, Tawil T, Nehme Jet al. Adenomyosis: An Updated Review on Diagnosis and Classification. J Clin Med. 2023;12(14):1-13. Dueholm M, Lundorf E. Transvaginal ultrasound or MRI for diagnosis of adenomyosis. Curr Opin Obstet Gynecol. 2007;19(6):505-12. Dietrich JE. An update on adenomyosis in the adolescent. Curr Opin Obstet Gynecol. 2010;22(5):388-92. Krentel H, Acien M. Adenomyosis in Adolescence. In: Endometriosis and Adenomyosis: Global Perspectives Across the Lifespan. 2022. Chapron C, Vannuccini S, Santulli P, Abrão MS, Carmona F, Fraser IS et al. Diagnosing adenomyosis: an integrated clinical and imaging approach. Hum Reprod Update. 2020;26(3):392-411. Abdulwahab Abdulkarim A. A Case of Severe Adenomyosis in a Young Adolescent. Sci J Clin Med. 2021;10(4):85. Itam SP, Ayensu-Coker L, Sanchez J, Zurawin RK, Dietrich JE. Adenomyosis in the Adolescent Population: A Case Report and Review of the Literature. J Pediatr Adolesc Gynecol. 2009;22(5):e146-7. Exacoustos C, Lazzeri L, Martire FG, Russo C, Martone S, Centini G, et al. Ultrasound Findings of Adenomyosis in Adolescents: Type and Grade of the Disease. J Minim Invasive Gynecol. 2022;29(2). Pinzauti S, Lazzeri L, Tosti C, Centini G, Orlandini C, Luisi S et al. Transvaginal sonographic features of diffuse adenomyosis in 18–30‐year‐old nulligravid women without endometriosis: association with symptoms. Ultrasound Obstet Gynecol. 2015;46(6):730-6. Mansouri R, Santos XM, Bercaw-Pratt JL, Dietrich JE. Regression of Adenomyosis on Magnetic Resonance Imaging after a Course of Hormonal Suppression in Adolescents: A Case Series. J Pediatr Adolesc Gynecol. 2015;28(6):437-40. Dason ES, Maxim M, Sanders A, Papillon-Smith J, Ng D, Chan C et al. Guideline No. 437: Diagnosis and Management of Adenomyosis. J Obstet Gynaecol Canada. 2023;45(6):417-29.e1.

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endometriosisadenomyosis

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