Adenomyosis or Not: The Ambiguity of Diagnostic Results and Clinician Incertitude

Adenomyosis is a benign gynecological condition caused by the presence of the endometrial glands within the uterine walls. This phenomenon occurs due to the breakdown of the inner lining of the uterus (endometrium) through the muscle wall of the uterus (myometrium). Usual symptoms are pelvic pain and irregular vaginal bleeding. As it is defined according to histological criteria obtained from a hysterectomy, diagnosis made based on only symptoms and imaging can be challenging. Discussed here is a case of a 30-year-old woman who presented with severe pelvic pain and irregular periods. Computing imaging (CT) and blood tests initially suggested malignancy but a review of magnetic resonance imaging (MRI) scans finally concluded adenomyosis. This clinical scenario elucidates for the utmost caution in the interpretation of investigations especially for the growing number of young women with this condition urging for more accurate diagnostic tools and effective communication between clinicians.