Precursor of adenomyosis cancer

Adenomyosis is a very common gynecological disease. This disease does not require treatment when there are no symptoms. Only when you often experience some symptoms will you need to receive corresponding treatment. If it is not treated, adenomyosis may become cancerous. You will feel some tenderness when you touch it with your hand, especially during menstruation, this tenderness will become more intense.

The main symptoms are excessive menstrual flow, prolonged menstrual period and gradually worsening progressive dysmenorrhea. The pain is located in the center of the lower abdomen and usually starts one week before menstruation until the end of menstruation. 35% of patients have no typical symptoms. The incidence of menorrhagia in patients with adenomyosis is 40%-50%, which is manifested by heavy menstrual bleeding in several consecutive menstrual cycles, generally greater than 80 ml, and affects women's physical, psychological, social and economic quality of life.

Excessive menstruation is mainly related to the increase in endometrial area, hyperplasia of myometrial fibrosis leading to poor contraction of the myometrium, and endometrial hyperplasia factors. The incidence of dysmenorrhea in adenomyosis is 15%-30%. Gynecological examination shows that the uterus is uniformly enlarged or has localized nodular protrusions, is hard and tender, and the tenderness is worse during menstruation. Asymptomatic cases are sometimes difficult to distinguish from uterine fibroids.

It should depend on the patient's symptoms, age and fertility requirements. There is no effective drug for radical cure. For patients with mild symptoms, fertility desire and near menopause, danazol, gestrinone or GnRH-α can be tried for treatment, which can relieve symptoms, but attention should be paid to the side effects of the drugs, and symptoms may recur after stopping the drugs.

During GnRH-α treatment, attention should be paid to the risk of bone loss in patients, and counter-additive therapy and calcium supplementation can be given. Young patients with adenomyoma or those who wish to have children can try lesion resection, but there is a risk of recurrence after surgery; for those with severe symptoms, no fertility requirements or ineffective drug treatment, total hysterectomy should be performed. Whether to preserve the ovaries depends on whether there are ovarian lesions and the patient's age.

A preliminary clinical diagnosis can be made based on typical progressive dysmenorrhea and a history of menorrhagia, and gynecological examination showing a uniformly enlarged or localized uterine protrusion, hardness, and tenderness. Imaging examinations are helpful to a certain extent and can be selected as appropriate. The definitive diagnosis depends on postoperative pathological examination.