Is adenomyosis a cancerous tumor?

Question

Hi doctor,

I have irregular periods with very heavy bleeding, clots, cramps, and stabbing pains in my pelvic area with no pattern connecting to bleeding. Some days, I am so fatigued and cannot function. This started five years ago. I had constant bleeding following coil insertion. Then it was removed and had a miscarriage at six weeks. When I was pregnant, there was no bleeding but I had spotting throughout. Since delivery, I have been suffering again with irregular and heavy bleeds. It became worse for the past eight months. I have IBS, which is stress-related. I am taking Adalat for high blood pressure, which is under control. I was prescribed Mefenamic acid and Tranexamic acid as I refused the coil due to previous bleeding with one and refused Esmya due to side effects. My transvaginal ultrasound found two polycystic ovaries and a bulky adenomyotic-looking anteverted uterus with vascular ++ on the anterior wall. The size was 0.7 x 1.1 x 0.3 inches. There are no fibroids or polyps or other pelvic masses or free fluid. Then what is it?

Kindly help.

Answer 1

Hi,

Welcome to icliniq.com.

The problem that you are facing is most likely due to the adenomyosis and polycystic ovaries. As you have not mentioned your age and the number of kids, it is really difficult to tell you the exact management. Because management is totally age-related and the number of kids you have. We can suggest you some hormonal treatment or surgical treatment based on your age and parity.

I hope this helps.

Answer 2

Hi,

Welcome back to icliniq.com.

As you are just 34 years old, opting directly for a hysterectomy is not a good option.

According to me, you should first undergo endometrial biopsy, which is an OPD procedure (outpatient department). Also, simultaneously, you can get Levonorgestrel intrauterine device inserted, which helps in reducing this kind of bleeding due to adenomyosis (uterus inner layer thickening). In case this device does not suit you, which you will come to know within three months after insertion, then you can think of undergoing a hysterectomy.

I hope this helps.

Answer 3

Hi,

Welcome back to icliniq.com.

Regarding vascular area, this could be due to adenomyosis. Adenomyosis has only a 1% chance of turning out to be cancerous, and 99% are non-cancerous. There is no specific way we can take a biopsy from that area, particularly. So, I had advised you to undergo an endometrial biopsy, which will give us some hint if it is cancerous. There are blood tests you can do, like CEA (carcinoembryonic antigen), CA 19-9, CA125, AFP (alpha-fetoprotein), or beta-hCG (human chorionic gonadotropin), which can give us an idea whether it is cancer or not. Get an MRI of the pelvis torule out cancer. If these tests come back negative, then definitely this is not cancer, and you can first go for medical therapy. If it fails, you can have a hysterectomy. If this comes back positive for cancer, then only hysterectomy is the first line of management.

Take care.