Abscess in Adenomyosis Mimicking a Malignancy in a54‐Year‐Old Woman

Erguvan R, Rezzan Erguvan, Mehmet M Meydanli, Meydanli MM, Mehmet Mutlu Meydanlı, Alkan A, Alpay Alkan, Mehmet N. Edali, Edali MN, Mehmet Naci Edalı, Hasan Gokce, Haşan Gökçe, Gokce H, Kafkasli A, Ayşe Kafkaslı, Ayşe Kafkasli
Infectious diseases in obstetrics and gynecology · 2003 · vol. 11(1) , pp. 59–64 · doi:10.1155/s1064744903000085 · PMID:12839634 · PMC1852262 · W2147347236
article OA: gold CC0 ⤵ 15 in-corpus citations
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This case report describes the first instance of an abscess forming within adenomyosis, which mimicked uterine malignancy in a postmenopausal woman and required intraoperative frozen section for diagnosis.

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Abstract

BACKGROUND: Although there are a few reports describing abscess formation in endometriotic foci no report of abscess formation arising de novo within adenomyosis appears in the literature. Preoperative diagnosis of adenomyosis is frequently difficult because of non-specific signs and symptoms. Synchronous pelvic pathologies such as leiomyoma, endometrial polyp, endometrial hyperplasia, as well as endometrial cancer may cause differential diagnostic problems. CASE: A 54-year-old postmenopausal woman complaining of inguinal pain, nightsweats and hot flashes is presented. Radiologic examinations of the pelvis revealed a 95 x 85 mm leiomyoma-like lesion including a 53 x 43 mm cystic space and 9 x 6 mm papillary formation within the uterus raising clinical suspicion of malignancy. A total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed accompanied by a frozen section diagnosis. The frozen section revealed an abscess formation arising in a focus of adenomyosis. The postoperative period of the patient was uneventful. CONCLUSION: The present case, to our knowledge, is the first report representing abscess formation in adenomyosis. Abscess arising within adenomyosis can strongly raise the suspicion of endometrial cancer, particularly if the patient is postmenopausal. If endometrial cancer cannot be ruled out with definitive histopathological diagnosis in the preoperative period, a frozen section becomes mandatory during surgical intervention.

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Condition tags

endometriosischronic_pelvic_painadenomyosis

MeSH descriptors

Abscess Endometriosis Uterine Diseases Abscess Abscess Abscess Biopsy, Needle Diagnosis, Differential Endometriosis Endometriosis Endometriosis Endosonography Endosonography Female Follow-Up Studies Humans Hysterectomy Hysterectomy Immunohistochemistry Middle Aged

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