Micro Abscess Formation in Adenomyotic Focus, a Rare Case

Case Report

J Fam Med. 2014;1(1): 2.

Micro Abscess Formation in Adenomyotic Focus, a Rare Case

Sahin B1, Demirtas O1, Karabulut A1* and Akbulut M2

1Department of Obstetrics and Gynecology, University of Pamukkale, Turkey

2Department of Pathology

*Corresponding author: Aysun Karabulut, Pamukkale University Medical School, Department of Obstetrics and Gynecology, Çamlaralti Mah.20070 Denizli/TURKEY

Received: July 23, 2014; Accepted: Aug 20, 2014; Published: Aug 23, 2014


Adenomyosis was defined as ectopic endometrial tissue in myometrium. A few cases of abscess formation in adenomyotic foci were reported previously. Herein, we presented a 53-year-old perimenopausal woman admitted with an abnormal vaginal bleeding and pelvic pain and hysterectomy material revealed micro abscess formation in adenomyotic foci. Micro abscess formation in adenomyotic foci may be further complicating the clinical picture by leading sepsis in postoperative period. Intensive antibiotic therapy in postoperative period has a crucial importance in treatment of suspected cases.

Keywords: Adenomyosis; Micro abscess formation; Myometrium

Case Presentation

A 53-year-old, multiparous, perimenopausal woman with complaint of vaginal discharge, and abnormal vaginal bleeding for last 5 days was admitted to outpatient clinic. In past medical history, she had chronic pelvic pain and dysmenorrhea which was resistant to non steroidal anti-inflammatory drugs for past 5 years. Menstrual history revealed normal cycles except heavy menses time to time.

Painful cervical movements and adnexal tenderness with globally enlarged uterus were detected on pelvic examination. Tran’s vaginal sonography revealed 130 x 103 x 96 mm uterus with 7 mm endometrial thickness, and 36x38 mm intramural myoma and minimal free fluid in the uterine cavity. Histopathologic examination of endometrial biopsy revealed secretary Endometrium.

Laboratory examination was remarkable for leukocytosis (14.000/ mm3) and elevated CA 125 (126.2 U/ml) level. Antimicrobial therapy composed of Gentamicin (Genta®, I.E. Ulagay, Istanbul, Turkey) and Clindamycin (Cleosin®, Pfizer, Istanbul, Turkey) were administered for a week followed by total abdominal hysterectomy and bilateral alpingo-oophorectomy. The patient was discharged without any complication three days after the surgery. Ca 125 levels returned to normal two weeks following the operation.

On histopathologic examination, adenomyotic foci characterized by endometrial glands embedded in their own stroma and extending deep into the myometrium were detected. Polymorpho nuclearleukocytes infiltrating the glandular epithelium and the stroma and micro abscess formation in adenomyotic focus was seen on pathologic exam (Figure 1).

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Citation:Sahin B, Demirtas O, Karabulut A and Akbulut M. Micro Abscess Formation in Adenomyotic Focus, a Rare Case. J Fam Med. 2014;1(1): 2. ISSN:2380-0658

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