A 45-years-old multipara presents with dysmenorrhea and menorrhagia.Uterus is symmetrically enlarged up to 14 weeks. What is the probable diagnosis?
Intramural fibroid
Adenomyosis
Endometrial hyperplasia
Pelvic inflammatory disease
AdenomyosisCommon in women above 40 years.Often co-exists with fibroid, endometriosis and endometrial cancer.Uterus is symmetrically enlarged to not more than 14 weeks size.Histology - Islands of endometrial glands surrounded by stroma seen in the myometrial tissue beyond the endomyometrial junction.The distance between basal endometrium and the endometrial gland should be > 2.5 mm.Common complaint--Menorrhagia and progressive dysmenorrhoea.Clinical examination reveals symmetrical enlargement of uterus and tender uterus.Treatment is localized excision, hysterectomy.Medical treatment includes danazol, GnRH, Mirena IUCD.(Refer: Shaw&;s Textbook of Gynaecology, 15th edition, pg no: 407, 475)
All India exam