Friday, March 21, 2008 3:15:04 PM
the short answer is yes
the long answer is adenomyosis is a difficult diagnosis. the gold standard actually requires a specimen and histology after hysterectomy to make the diagnosis after the fact. however, there are some sono criteria that suggest adenomyosis (as well as MRI)
there really is no consensus on how to manage, but if someone is in pain, imaging suggests adenomyosis - lupron may help. on one hand adenomyosis may be thought of as a variant of endometriosis, but in the latter the ectopic location of the glands is in the myometrium (muscle of the uterus) rather than the pelvis/abdomen. what is unique is that this "invasion" if you will of the myometrium by endometrium often spurs hypertrophy of the surrounding myometrium, so uteri may be enlarged and in that sense mimick a fibroid uterus (before good sonography, and even today, pts may be taken to surgery for fibroids only to discover there are poor disection planes and what the pt probably has is adenomyosis)
more significantly than adenomyosis - pts with uterine bleeding from causes other than fibroids are likely to be candidates for proellex - something i have said on this board previously and which i speculated may have been the reason the FDA required a separate anemia IND (to be able to handle these follow on indications)
the long answer is adenomyosis is a difficult diagnosis. the gold standard actually requires a specimen and histology after hysterectomy to make the diagnosis after the fact. however, there are some sono criteria that suggest adenomyosis (as well as MRI)
there really is no consensus on how to manage, but if someone is in pain, imaging suggests adenomyosis - lupron may help. on one hand adenomyosis may be thought of as a variant of endometriosis, but in the latter the ectopic location of the glands is in the myometrium (muscle of the uterus) rather than the pelvis/abdomen. what is unique is that this "invasion" if you will of the myometrium by endometrium often spurs hypertrophy of the surrounding myometrium, so uteri may be enlarged and in that sense mimick a fibroid uterus (before good sonography, and even today, pts may be taken to surgery for fibroids only to discover there are poor disection planes and what the pt probably has is adenomyosis)
more significantly than adenomyosis - pts with uterine bleeding from causes other than fibroids are likely to be candidates for proellex - something i have said on this board previously and which i speculated may have been the reason the FDA required a separate anemia IND (to be able to handle these follow on indications)
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