EP33.15: Case report: particular case of focal adenomyosis

A 44-year-old woman, no medical history of interest or previous sexual relations. Refers palpation of abdominal mass and heavy menstrual bleeding in recent years. In the speculoscopy exploration an atypical aspect mass protrudes through the OCE. No parametrial involvement. Transvaginal ultrasound: hyperechoic tumour with a thickness of 90x63x79 mm, heterogeneous with irregular appearance of junctional-zone (JZ). Vascularisation in the Doppler study 3/4 with multifocal origin. The tumour impress to infiltrate cervical stroma. Endometrial neoplasia can not be ruled out with infiltration> 50% in the anterior isthmus face. Rest of myometrium of heterogenic echogenicity. Magnetic resonance: multiquisitic mass with solid areas that occupies and distends endometrial and endocervical cavity until OCE suggestive of endometrial origin. It seems to have an endometrial origin with> 50% myometrial infiltration. Endometrial biopsy: endometrial mucosa in proliferative phase. Tumour markers were negative. As a treatment a hysterectomy was performed. Definitive AP: adenomyosis with endometrial hyperplasia without atypias. The ultrasonographic findings according to the MUSA criteria of adenomyosis visualised in this case are the subendometrial cysts and the irregular JZ with heterogeneous myometrium. Despite this, IETA criteria proposed as endometrial risk factors: > 15 mm, multifocal vascularisation and the presence of irregular cysts; thus, in this patient without clear risk factors for adenomyosis, it is mandatory to perform the differential diagnosis of endometrial neoplasia. Hysterosonography could help to better define the endmetrium in doubtful cases. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.