Adenomyosis in acromegaly

И. В. Станоевич, Svetlana Vorotnikova, Л С Селиванова, Anna Tarasova, О. В. Иващенко, Н. В. Тарбаева
In: Voprosy ginekologii, akušerstva i perinatologii · 2018 · vol. 17(3) , pp. 116–123 · doi:10.20953/1726-1678-2018-3-116-123 · W2888676739
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This case report describes adenomyosis in a patient with acromegaly, noting faster progression, absent algomenorrhea, higher CA-125, and specific morphological features.

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This case report describes a 37-year-old woman presenting with stage 3 adenomyosis and secondary iron-deficiency anemia in the context of active acromegaly. The authors highlight distinct clinical features, including rapid disease progression, atypical absence of painful menstruation, elevated CA-125 levels, and specific morphological findings such as stromal prevalence in heterotopias and myometrial hypertrophy. They propose that enhanced growth hormone and interferon signaling may potentiate uterine endometriosis, although they note this mechanism requires further specification. This paper is centrally about adenomyosis — specifically examining its unique clinico-morphological presentation and potential pathogenic mechanisms in a patient with comorbid acromegaly.

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Gynecology, Obstetrics and Perinatology - Gynecology, Obstetrics and Perinatology - 2018 volume 17 issue 3 Adenomyosis in acromegaly Authors / Institutions I.V.Stanoevich / S.Yu.Vorotnikova / Liliya S. Selivanova / А.V.Тarasova / Оksana V. Ivashchenko / N.V.Тarbaeva / A clinical case of a 37-year-old patient with adenomyosis at stage 3 of enlargement, resulting in uterine enlargement to 14–15 wks, menorrhagias with the development of secondary iron-deficiency anaemia grade 2 against the background of the onset and manifestation of acromegaly. Clinical specificities of uterine endometriosis in acromegaly were fast progression, absence of pathognomonic algomenorrhoea and also of complaints and symptoms characteristic for anaemia, higher levels of СА-125, absence of combined leyomyoma and endometrial hyperplasia, prevalence of the stromal component in endometrioid heterotopias in combination with marked hypertropy of the adjacent myometrium at morphological examination. The above clinico-morphological specificities of adenomyosis in a patient at an active stage of acromegaly might be indicative of potentiation of uterine endometriosis in the presence of enhanced GH-IFN-1 signalling, which requires further specification. Key words: adenomyosis, acromegaly, anaemia, IFN-1, СТГ, СА-125. For citation: Stanoevich I.V., Vorotnikova S.Yu., Selivanova L.S., Тarasova А.V., Ivashchenko О.V., Тarbaeva N.V. Adenomyosis in acromegaly. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2018; 17(3): 116–123. (In Russian). DOI: 10.20953/1726-1678-2018-3-116-123 Key words: adenomyosis, acromegaly, anaemia, IFN-1, СТГ, СА-125. For citation: Stanoevich I.V., Vorotnikova S.Yu., Selivanova L.S., Тarasova А.V., Ivashchenko О.V., Тarbaeva N.V. Adenomyosis in acromegaly. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2018; 17(3): 116–123. (In Russian). DOI: 10.20953/1726-1678-2018-3-116-123

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