An unexpected diagnosis of adenomyosis in the subfertile woman

Tia Hunjan, Andrew Davidson
BMJ case reports · 2015 · vol. 2015 , pp. bcr2014209012 · doi:10.1136/bcr-2014-209012 · PMID:25725032 · W1996809865
article OA: bronze CC0 ⤵ 3 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes a misdiagnosis of uterine fibroids instead of deeply penetrating adenomyosis in a subfertile woman, leading to an unexpected hysterectomy.

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Abstract

A 38-year-old nulliparous female presented to an assisted conception clinic with subfertility and a long-standing history of dysmenorrhoea. Transvaginal ultrasound revealed two lesions in the body of the uterus, which were presumed to be fibroids. A decision was made to remove these lesions prior to attempting in vitro fertilisation (IVF). However, on laparotomy, deeply penetrating adenomyosis was discovered, resulting in an unexpected hysterectomy and significant blood loss. Based on our experience, we highlight the importance of suspecting a diagnosis of adenomyosis preoperatively and the methods by which this diagnosis can be made, in order to avoid potential unforeseen outcomes as described in this case. We discuss conservative management options for this condition, particularly in women wishing to preserve fertility.

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Condition tags

mesh:D004412adenomyosisdysmenorrhea

MeSH descriptors

Adenomyosis Infertility, Female Adenomyosis Adenomyosis Adult Blood Loss, Surgical Blood Transfusion Diagnosis, Differential Dysmenorrhea Dysmenorrhea Female Humans Hysterectomy Infertility, Female

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (39)

Cited by (3)

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