Adenomyosis and ‘endometrial– subendometrial myometrium unit disruption disease’ are two different entities

Angelo Tocci, Tocci A, Ermanno Greco, Greco E, Filippo Maria Ubaldi, Ubaldi FM
Reproductive BioMedicine Online · 2008 · vol. 17(2) , pp. 281–291 · doi:10.1016/s1472-6483(10)60207-6 · PMID:18682005 · W2031859613
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This paper distinguishes adenomyosis from 'endometrial–subendometrial myometrium unit disruption disease,' asserting they are separate pathological entities.

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Abstract

The diagnosis of adenomyosis is feasible on pathological specimen examination, while it is unreliable on clinical findings, biopsy, hysteroscopy, sonohysterography, and routine ultrasound or magnetic resonance imaging. Several patterns of 'abnormality' described on imaging have been linked to adenomyosis, but the correlation is weak and the diagnostic accuracy is low outside of a research context. Nevertheless, thickening or abnormality of the subendometrial myometrium, the outer part of the 'endometrial-subendometrial myometrium unit' (thought to be important in human fertility) has been repeatedly documented on imaging, called 'adenomyosis' and linked to infertility. This paper discusses the value of the physiological endometrial-subendometrial myometrium unit in human fertility, reviews the current criteria for its imaging, and reports on its relationship to fertility. It is proposed that endometrial-subendometrial myometrium unit disruption disease is considered as a new entity (distinguished from adenomyosis), the diagnosis of which is feasible and straightforward on imaging and expressed mainly by pathological thickening or abnormality of the subendometrial myometrium (myometrial halo or junctional zone). The study also reports on the influence of abnormal thickening or disruption on human fertility and outcome of assisted reproduction techniques, and demonstrates that this new entity is epidemiologically different from adenomyosis.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Endometriosis Uterine Diseases Biopsy Biopsy Diagnosis, Differential Endometriosis Endometriosis Endometriosis Endometriosis Female Humans Hysteroscopy Hysteroscopy Infertility, Female Infertility, Female Magnetic Resonance Imaging Magnetic Resonance Imaging Ultrasonography Ultrasonography Uterine Diseases

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 (100)

Cited by (35)

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