Ulipristal acetate therapy increases ultrasound features of adenomyosis: a good treatment given in an erroneous diagnosis of uterine fibroids

Francesca Conway, Giulia Morosetti, G. Morosetti, S. Camilli, Sara Camilli, Francesco Giuseppe Martire, Giuseppe Sorrenti, Emilio Piccione, Errico Zupi, Caterina Exacoustos, C. Exacoustós
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2018 · vol. 35(3) , pp. 207–210 · doi:10.1080/09513590.2018.1505846 · PMID:30382803 · W2898989740
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Ulipristal acetate treatment for presumed uterine fibroids in adenomyosis patients worsened ultrasound features and increased pelvic pain.

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Abstract

Ulipristal acetate (UPA) is used for medical treatment of uterine fibroids. The aim of this study was to describe the effects on painful symptoms and the sonographic uterine modifications in patients with adenomyosis erroneously treated with UPA. This is an observational study on six women affected by adenomyosis and treated with three months of UPA (5 mg/24h). The baseline ultrasonography (US) was not performed at out center nor was the diagnosis of fibroids. The patients came to our attention after the treatment with UPA, prescribed by an external physician. During our post-treatment scan we found aspects of adenomyosis, while no fibroids were detected. Symptoms, myometrial and endometrial ultrasound features were evaluated. All patients reported an increase in pelvic pain. At US evaluation intramyometrial cystic areas were found in all six cases (100%). All patients showed an enhancement of adenomyosis features.The intra-myometrial cysts appeared enlarged and the vascularization enhanced when compared to the images of the pretreatment scan. In patients with adenomyosis treated with UPA due to an erroneous diagnosis of uterine fibroids we observed a worsening of the US features of adenomyosis and of the painful symptoms.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Leiomyoma Norpregnadienes Ultrasonography Uterine Neoplasms Uterus Adenomyosis Diagnostic Errors Disease Progression Female Humans Leiomyoma Leiomyoma Middle Aged Norpregnadienes Norpregnadienes Uterine Neoplasms Uterine Neoplasms Uterus Uterus

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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.

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