What are the other Names for this Condition? (Also known as/Synonyms)

• Adenomyoma of Cervix
• Cervical Adenomyoma

What is Adenomyoma of Uterine Cervix? (Definition/Background Information)

• Adenomyoma of Uterine Cervix is a tumor that involves the benign endocervical-type glands and benign stroma. It is classified as a mixed epithelial and mesenchymal tumor of the uterine cervix
• This benign tumor is mostly found in middle-aged women, who frequently have medical issues related to menstruation. In some cases, the tumors are generally painless and asymptomatic
• Some women with Adenomyoma of Cervix may have heavy bleeding during menstruation and irregular periods. Large tumors sizes can cause signs and symptoms due to compression of adjoining organ structures
• The treatment of choice for Adenomyoma of Uterine Cervix is a surgical removal of the entire tumor. In a majority, the prognosis is excellent with appropriate treatment, since it is a benign tumor

Who gets Adenomyoma of Uterine Cervix? (Age and Sex Distribution)

• Adenomyoma of Uterine Cervix may affect females of a wide age range, but is mostly observed in the age range 21-55 years (average 40 years)
• There is no geographical, racial, or ethnic preference noticed

What are the Risk Factors for Adenomyoma of Uterine Cervix? (Predisposing Factors)

• No specific risk factors are noted for Adenomyoma of Uterine Cervix
• However, the tumor typically develops in premenopausal women who have irregular periods, menstruation-related problems, and abnormal bleeding

The following factors may also favor the formation of Cervical Adenomyoma:

• Family history of the condition
• Imbalance of estrogen and progesterone hormone levels in the body
• Early onset of menstruation (in girls)
• Obesity, being overweight
• High in meat and low in vegetables diet
• Vitamin D deficiency
• Excessive alcohol consumption

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Adenomyoma of Uterine Cervix? (Etiology)

• The exact cause of Adenomyoma of Uterine Cervix development is unknown
• Research is being performed to understand the causative factors of this benign condition

What are the Signs and Symptoms of Adenomyoma of Uterine Cervix?

A majority of women may not experience any signs and symptoms of Adenomyoma of Uterine Cervix. In some cases, the signs and symptoms may include the following:

• The tumor arises in the cervix (which is the lower neck-like portion of the uterus) and it involves the endocervical-type glands
• The tumors are generally painless
• Adenomyomas are well-defined, firm tumors that appear like polyps or appear as a mass, mostly on the cervical wall
• Adenomyomas may contain many mucinous cysts of varying sizes (few cms)
• The tumors may range in size from 1-10 cm
• Women may experience irregular periods and related problems; abnormal vaginal bleeding may also be observed during menstruation
• Some large polypoid tumors may push into the endocervical canal
• Large tumors may compress adjoining organs and structures; it may cause a feeling of fullness in the abdomen
• Enlargement of lower abdomen
• Frequent urination due to compression/pressure of the tumor
• Lower back pain
• Some women may not experience any symptoms

Note: These tumors resemble their counterparts in the uterus; however, unlike uterine adenomyomas, no variants of cervical adenomyomas are observed.

How is Adenomyoma of Uterine Cervix Diagnosed?

The diagnosis of Adenomyoma of Uterine Cervix may involve the following tests and procedures:

• Complete physical examination with thorough evaluation of medical history
• Ultrasound scan of the pelvis: It is a noninvasive procedure that uses high frequency sound waves to produce real-time images
• Abdominal and pelvic CT scan: It is a noninvasive procedure that provides more details of soft tissues, blood vessels, and internal organs
• Pelvic MRI scan: It is a noninvasive medical test that uses a powerful magnetic field to produce images of soft tissues, bones, organs, and all other internal structures of the abdomen and pelvis
• Blood tests that include:
  • Complete blood count (CBC) to detect the cause of anemia
  • Determination of estrogen/progesterone levels in blood
• Hysteroscopy: This procedure involves placing a probe through the cervix to examine the cavity of the uterus
• Colposcopy:
  • The cervix is examined with an instrument, called a colposcope. This helps the physician get a magnified view of the cervix
  • In order for this procedure to be performed, the individual has to lie on a table, as for a pelvic exam. An instrument, called the speculum, is placed in the vagina to keep the opening apart, in order to help the physician visualize the cervix. The colposcope is then used to get a magnified view of the inside

Tissue biopsy of the mass:

• A tissue biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
• Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
• Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and very rarely, electron microscopic studies to assist in the diagnosis

Note:

• Differential diagnosis, to eliminate other tumor types is considered, before arriving at a definitive diagnosis
• Cervical Adenomyoma may be diagnostically confused with endocervical adenocarcinoma (a type of cervical cancer)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Adenomyoma of Uterine Cervix?

The possible complications of Adenomyoma of Uterine Cervix include:

• Stress and anxiety due to fear of cancer of the uterus
• Polypoid tumors may undergo mechanical injury, such as torsion or twisting, which can result in excruciating pain
• The polyps may cause cervical prolapse
• Recurrence of the tumor due to its partial or incomplete surgical removal
• There may be complications due to the tumor in pregnant women

How is Adenomyoma of Uterine Cervix Treated?

The following treatment methods may be employed to treat Adenomyoma of Uterine Cervix:

• Asymptomatic tumors may not require any treatment; in such cases, the healthcare provider may chose to periodically observe and monitor the tumor, once Cervical Adenomyoma is diagnosed
• Medical treatment options:
  • Pain medications
  • Dietary and lifestyle modification to address overweight issues
• Surgical treatment options: A simple surgical excision and removal of the entire tumor is normally sufficient treatment
  • Myolysis: In this procedure, a needle is inserted into the tumor. After the insertion, the tumor is destroyed either by using an electric current, or by a freezing technique
  • Hysterectomy: The removal of a part of the uterus or the entire uterus for large-sized tumors, if the women has ‘completed her family’
  • Tumor embolization is a possible treatment option. Here the blood supply to the tumor is blocked resulting in its death
  • Radiofrequency ablation: In this technique, the tumors are destroyed using radio waves
• Post-operative care is important: One must maintain minimum activity levels, until the surgical wound heals
• Follow-up care with regular screening and check-ups are important

How can Adenomyoma of Uterine Cervix be Prevented?

Current medical research has not established a way of preventing Adenomyoma of Uterine Cervix. However, the following factors may be considered to reduce the risk for Cervical Adenomyomas:

• Address any condition causing hormonal imbalance in the body
• Maintain weight through proper diet modification and physical exercises, if you are overweight/obese
• Avoid alcohol consumption or limit its intake
• Have a balanced diet that is not high in meat and low in vegetables; a balanced diet can also help avoid any mineral or vitamin deficiencies in the body
• Regular medical screening at periodic intervals with blood tests, radiological scans, and physical examinations are recommended

What is the Prognosis of Adenomyoma of Uterine Cervix? (Outcomes/Resolutions)

• In a majority, the prognosis of Adenomyoma of Uterine Cervix is generally excellent on surgical excision and removal of the tumor
• Large tumors causing significant signs and symptoms may complicate the prognosis. Excessive bleeding causing severe anemia may result in signs and symptoms that may adversely affect the outcome

Additional and Relevant Useful Information for Adenomyoma of Uterine Cervix:

The following DoveMed website links are useful resources for additional information:

http://www.dovemed.com/healthy-living/womens-health/

http://www.dovemed.com/diseases-conditions/cancer/