Cited by 359Endometriosis Research and TreatmentUterine Myomas and TreatmentsGynecological conditions and treatments

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Pathology and physiopathology of adenomyosis

Bergeron, Christine, Amant, Frederic, Ferenczy, Alex·2006·Best Practice & Research Clinical Obstetrics & Gynaecology

DOI 10.1016/j.bpobgyn.2006.01.016

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Abstract

Adenomyosis is defined by the presence of endometrial mucosa within the myometrium. This probably occurs by invagination of the basalis endometrium into the myometrium. The process of invagination and intramyometrial spreading may be facilitated by the non-cyclic, anti-apoptotic activity of the basalis associated with relative hyper-oestrogenic states. Most cases of adenomyosis are discovered in multiparous women during the 'transitional' years (40-50 years), and the condition is associated with menorrhagia, dysmenorrhoea, endometrial polyps and leiomyomata uteri. Endometrioid adenocarcinoma is often associated with adenomyosis, is frequently of early stage and low histological grade, is hormone-sensitive, and has an excellent prognosis. Extension of malignant growth into foci of adenomyosis has no adverse effect on prognosis. Definite diagnosis and treatment of adenomyosis are obtained by hysterectomy. Although adenomyotic endometrial glands are hormone-sensitive, exogenous progestogenic agents are ineffective for the treatment of adenomyosis. Anti-oestrogenic danazol and gonadotrophin-releasing hormone (GnRH) analogues induce suppression of adenomyosis, but their use must be of short duration. Surgical extirpation, therefore, is the best therapeutic option.

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Background
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Background
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BackgroundInfluential
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Background
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Background
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Background
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Background
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Background
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BackgroundInfluential
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Background
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“to a short-term treatment due to its side effects and recurring symptoms after discontinuation of GnRH-a therapy (7,8).”
Background
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“21,22 In contrast to individuals with adenomyosis away from the endometrium, those with adenomyotic lesions near the endometrium and thickening of the myometrial wall F I G U R E 5 AUB-A.”
Background
US, MRI, CT Performance and Interpretation of Uterine Masses
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“Introduction Adenomyosis is one of the most common disorders in women, and it is defined as the presence of endometrial and stromal glands in tissue, which can be accompanied by hyperplasia and hypertrophy of the myometrium (1-10).”
Background
Serum level concentrations of pro-inflammatory cytokines in patients with adenomyosis
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“Adenomyosis presents in different configurations, including diffuse, focal, and, rarely, cystic adenomyomas [4,5].”
Background
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Kay, N., Huang, C., Yu, Y.-C., Chen, C., Chang, C., & Huang, S.-T. J. (2025) · American Journal Of Pathology · doi:10.1016/j.ajpath.2025.01.014 · Cited by 3
NOTCH1- and CD117-Positive Stem Cells in Human Endometriosis and Adenomyosis Lesions
Metodiev, D., Parvanov, D. A., Ruseva, M., Ganeva, R., Handzhiyska, M., Vidolova, N., Chavoushian, A., Hadjidekova, S. P., & Stamenov, G. (2024) · Diagnostics · doi:10.3390/diagnostics14151642 · Cited by 3
“Adenomyosis is defined as the presence of endometrial glands and stroma within the myometrium [2].”
Background
Systematic review and meta‐analysis of adverse pregnancy outcomes with different types of adenomyosis
Ying, X., & Yu, H. (2025) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.70272 · Cited by 3
Pre-conception Risk Assessment: Gynaecological Problems
Karasu, T., & Metwally, M. (2016) · Springer eBooks · doi:10.1007/978-3-319-42858-1_2 · Cited by 3
Role of Epithelial-Mesenchymal Transition in Human Adenomyosis: A New Insight into Its Pathogenesis
Khan, K. N. (2018) · Comprehensive gynecology and obstetrics · doi:10.1007/978-981-10-7167-6_9 · Cited by 3
Uterine Adenomyosis in Beagle Dogs
Kim, H. S., Kang, S. C., Zhang, H.-S., Kang, J. S., Kim, J., Kim, K.-H., Kang, B.-H., & Yoon, B. (2010) · Laboratory Animal Research · doi:10.5625/lar.2010.26.2.211 · Cited by 3
“But unlike leiomyoma, adenomyosis has indistinct, poorly delimited margins from the adjacent myometrium (Bergeron et al., 2006).”
BackgroundInfluential
Decreased expression of cell polarity protein Scribble correlated with altered subcellular localization of the Crumbs homologue 3 protein in human adenomyotic endometrial cells
Wu, X., Zuo, W., Liu, H., Wang, Z., & Xu, C. (2019) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.13952 · Cited by 3
“Scrib IHC score was calculated by percentage of positive cells ranging from 0 to 100% and intensity of staining, which was graded as absent (0), weak,(25) moderate(6) and strong.(4) The bottom and top of the dot area represent the lower and upper quartiles respectively, the band in the middle represents the median.”
Method
The Correlation of Adenomyosis with Benign Endometrial Lesions in Hysterectomy Samples
Ranaei, M., Kohsari, E., Galeshi, M., & Yazdani, S. (2019) · Journal of Obstetrics Gynecology and Cancer Research · doi:10.30699/jogcr.4.3.99 · Cited by 3
The Impact of Uterine Disorders on Embryo Implantation and Early Survival: From Molecular Insights to Clinical Evidence
Etrusco, A., Riemma, G., Chiantera, V., Laganà, A. S., Agrifoglio, V., Donna, M. C. D., Pecorino, B., Scibilia, G., Tinelli, A., Malvası, A., et al. (2025) · Gynecologic and Obstetric Investigation · doi:10.1159/000543836 · Cited by 3
“…could determine an alteration of the junctional zone, leading to the invasion of endometrial basalis cells or cell clusters into the myometrium [126], as showed by the higher prevalence in women with prior multiple instances of sharp endometrial curettage, cesarean sections, and previous…”
The etiology differs regards to the locations of the lesion: a clinical experience of 1350 patients with adenomyosis confirmed by postoperative pathology
Li, W., Hang, Y., Xu, Y., Zhang, W., He, Y., Ye, W., Hu, X., & Wei, Z. (2025) · BMC Women s Health · doi:10.1186/s12905-025-03759-3 · Cited by 2
Pregnancy Outcomes With and Without Adenomyomectomy in Infertile Patients With Adenomyosis: A Single‐Center Retrospective Study
Hamaguchi, F., Kitawaki, Y., Ohara, T., Miyamoto, T., Okunomiya, A., Sunada, M., Okada, Y., Mandai, M., & Horie, A. (2025) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.70149 · Cited by 2
Spatial transcriptomics uncovers the hybrid molecular identity, ciliated phenotype, and immune signature of adenomyosis lesions
Maclean, A., Johnson, E., Rushworth, C., Hill, C. J., Caamaño‐Gutiérrez, E., & Hapangama, D. K. (2026) · Science Advances · doi:10.1126/sciadv.aea6379 · Cited by 4
“This observation supports the hypothesis that adenomyosis originates from the invasion of endometrial basalis into the myometrium ( 20 , 22 , 31 ) and reveals the influence of previously unknown cell types such as myometrial cells on adenomyosis pathogenesis.”
Study of prevalence of endometrial cancer in patients with adenomyosis uteri
Essmat, A. A. A. (2021) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.18203/2320-1770.ijrcog20214627 · Cited by 2
MRI of Adenomyosis: Where Are We Today?
Zhang, M., Bazot, M., Tsatoumas, M., Munro, M. G., & Reinhold, C. (2022) · Current Obstetrics and Gynecology Reports · doi:10.1007/s13669-022-00342-7 · Cited by 2
“5 mm from the endo-myometrial junction, others use greater than 1 microscopic field at ×10 magnification (about 2-3 mm) from the endomyometrial junction or heterotopic glands located deeper than 25% of the myometrium thickness.(10,41,65,67,68) The lack of a standardized histopathological protocol likely contributes to…”
Method
RETRACTED ARTICLE: The importance of vitamin D in the diagnosis and treatment of adenomyosis
Moldassarina, R. S., Манабаева, Г. К., Akylzhanova, Z. E., & Rashidova, A. M. (2022) · Molecular and Cellular Biochemistry · doi:10.1007/s11010-022-04533-x · Cited by 2
“The characterisation of clinical and biochemical parameters of blood, urine, and tissues of removed organs contributes to a clinical and final diagnosis, the determination of concomitant pathology, complications, and therapeutic measures in the dynamics of observation [2].”
Influential
Retracted
Does coexistence of endometrial cancer and adenomyosis affect survival outcomes? A retrospective cohort study
(2023) · European Journal of Gynaecological Oncology · doi:10.22514/ejgo.2023.112 · Cited by 2
“[11].”
BackgroundInfluential
Cystic Adenomyoma in Pregnancy: A Case Report
Verta, S., Brambs, C., & Christmann, C. (2024) · International Journal of Women s Health · doi:10.2147/ijwh.s450701 · Cited by 2
The Patient with Non–Pregnancy-Associated Vaginal Bleeding
Dyne, P. L., & Miller, T. A. (2019) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2019.01.002 · Cited by 2
PIWIL2 is overexpressed in adenomyotic lesions of women with diffuse adenomyosis
Mattia, M. M. C., Fernandes, A. C. P., Genro, V. K., de Souza, C. A. B., Olsen, P. D. R., & Cunha‐Filho, J. S. (2020) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-020-05660-w · Cited by 2
Uterine Embolization as a New Treatment Option in Adenomyosis Uteri
Tsikouras, P. N., Gaitatzi, F., Filiou, S., Michalopoulos, S., Gerede, A., Tsalikidis, C., Zervoudis, S., Bothou, Α., Vatsidou, X., Chalkidou, A., et al. (2022) · IntechOpen eBooks · doi:10.5772/intechopen.101480 · Cited by 3
Adenomyosis and fertility: a modern view of the problem. A literature review
Bezhenar, V. F., Анатольевич, Л. В., Arakelyan, B. V., Kalugina, A. S., Vasilyev, Y. V., Sobakina, D. A., Sadykhova, E. E., & Tarasenkova, V. A. (2022) · Journal of obstetrics and women s diseases · doi:10.17816/jowd78939 · Cited by 2
CLINICOPATHOLOGICAL AND RADIOLOGICAL COMPARISON OF ADENOMYOSIS IN HYSTERECTOMY PATIENTS – A RETROSPECTIVE STUDY
Rohit Kumar, C. (2019) · GLOBAL JOURNAL FOR RESEARCH ANALYSIS · doi:10.36106/gjra/0600459 · Cited by 2
An Update on the Various Theories of the Origin of Uterine Adenomyosis –A Systematic Review
Kaur, K. K., Allahbadia, G., & Singh, M. (2020) · Archives of Urology · doi:10.22259/2638-5228.0301004 · Cited by 2
Association Between Adenomyosis and Cervical Cancer: A Retrospective Cohort Study
Yang, T., Chen, X., Hua, K., & Li, C. (2024) · Journal of Investigative Surgery · doi:10.1080/08941939.2024.2430707 · Cited by 1
“In addition, some studies have reported that adenomyosis is associated with alterations in gene expression related to cell cycle regulation, proliferation, and cell death (including PTEN, KRAS, RB1, and PIK3CA), which may result in decreased tumor progression [5, 20–22].”
Modulatory role of epigallocatechin-3-gallate (EGCG) on male and female reproductive disorders
Roy, N., Borle, S., & Singh, D. (2025) · Reproductive Toxicology · doi:10.1016/j.reprotox.2025.109049 · Cited by 1
Temporal dynamics of uterine immune microenvironment remodeling in a murine model of adenomyosis
Squatrito, M., Vervier, J., Bernet, L., Camboni, A., Dolmans, M., & Munaut, C. (2025) · Molecular Human Reproduction · doi:10.1093/molehr/gaaf057 · Cited by 1
“Since the initial theory positing that endometrial tissue pene-trates the myometrium through a compromised junctional zone (Bergeron et al. , 2006; Stratopoulou et al. , 2021), numerous molecular pathways have been explored to elucidate pathogenesis.”
Impact of junctional zone adenomyosis on reproductive outcomes after first single embryo transfer with donated oocytes: A retrospective single‐center cohort study
Etrusco, A., Renau, B. M., Agrifoglio, V., Maiorana, A., Farfan, J. C., & Bernabeu, A. (2026) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.70991 · Cited by 1
Is There a Place for UAE in Adenomyosis?
Lohle, P. N. M. (2012) · Medical radiology · doi:10.1007/174_2012_626 · Cited by 1
Narrative review of hysteroscopy and endometriosis treatment
Lasmar, R. B., & Lasmar, B. P. (2021) · Gynecology and Pelvic Medicine · doi:10.21037/gpm-2020-es-01 · Cited by 1
Mesenchymal Tumors of the Uterus
Oliva, E., Zaloudek, C. J., & Soslow, R. A. (2018) · Springer eBooks · doi:10.1007/978-1-4614-3165-7_10-2 · Cited by 1
Endometriosis and adenomyosis: common and disparate features
Deryabina, V. A., Brus, T. V., & Pyurveev, S. S. (2022) · Pediatrician (St Petersburg) · doi:10.17816/ped13581-97 · Cited by 2
The Role of Ultrasound in Women’s Health
Kumsa, M. J., & Haile, Z. W. (2023) · IntechOpen eBooks · doi:10.5772/intechopen.111821 · Cited by 1
Analysis of MRI imaging characteristics in 10 cases of adult granulosa cell tumor with normal estrogen levels
Weng, W., Chen, Y., Liu, Z., Chen, W., Hu, J., Chen, H., Pan, X., Wu, H., & Chi, X. (2024) · BMC Medical Imaging · doi:10.1186/s12880-024-01529-5 · Cited by 1
THE CLINICAL EFFICACY OF SEQUENTIAL USE OF GONADOTROPIN-RELEASING HORMONE ANALOG - LEVONORGESTREL-RELEASING INTRAUTERINE SYSTEM IN MEDICALLY ILL WOMEN WITH SYMPTOMATIC AND RELATIVELY LARGE ADENOMYOSIS
Alizzi, F. J. (2018) · Asian Journal of Pharmaceutical and Clinical Research · doi:10.22159/ajpcr.2018.v11i9.26847 · Cited by 1
“Adenomyosis is a frequent cause of abnormal uterine bleeding (AUB), dysmenorrhea, and uterine enlargement in women in their reproductive years [1].”
Background
PATHOLOGICAL DISCHARGE FROM THE UTERINE BODY
Abdinazarova, I. S., Atakhanova, N. E., & Исраиловна, Т. Н. (2023) · Oriental Journal of Medicine and Pharmacology · doi:10.37547/supsci-ojmp-03-02-07 · Cited by 1
“Аденомиоз хеч қандай симптомларсиз 33%, қовуқ сохасида доимий оғриқ билан 77%, 40-60% оғир бачадондан анормал қон кетиши билан кечади ва 1-3% эндометриал саратонга айланиши мумкин [6,18,24,26,29].”
Analyse von Nervenfasern und Nervenwachstumsfaktoren in der Adenomyose
Wagner, F. (2013) · Universitätsbibliothek der FU Berlin Hochschulschriftenstelle u. Dokumentenserver · doi:10.17169/refubium-5948
Diagnóstico de la adenomiosis
Brun, J.-L., Botolahy, Z. A., Benjoar, M., Marty, M., & Bazot, M. (2014) · EMC - Ginecología-Obstetricia · doi:10.1016/s1283-081x(14)69283-3
Surgical management of cystic adenomyosis. Why the laparoscopic approach is preferable?
Calagna, G. (2014) · Giornale italiano di ostetricia e ginecologia · doi:10.11138/giog/2014.36.3.370
“it is defined as a circumscribed nodule, also known as adenomyoma or cystic adenomyosis (6), that presents a cystic aspect.”
Background
Is adenomyosis, a frequent association of abnormal uterine bleeding? : a retrospective study on hysterectomy samples in the rural area of Melmaruvathur
Sumathi, S. (2016) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.18203/2320-1770.ijrcog20160883

Authors: Bergeron, C., Amant, F., & Ferenczy, A.
Affiliations: Processus d'Activation Sélective par Transfert d'Énergie Uni-électronique ou Radiatif (FR)
Jewish General Hospital (CA)
Corresponding author: Bergeron, Christine
ORCID: Bergeron, Christine
Venue: Best Practice & Research Clinical Obstetrics & Gynaecology
Publisher: Elsevier BV
Published: 2006-08
Volume: 20
Issue: 4
Pages: 511-521
ISSN: 1521-6934 (ISSN-L)
DOI: 10.1016/j.bpobgyn.2006.01.016
OpenAlex: W2038354928
Cited by: 359
References: 54
Citations by year: 2026: 13 · 2025: 16 · 2024: 19 · 2023: 33 · 2022: 25 · 2021: 36 · 2020: 35 · 2019: 26 · 2018: 19 · 2017: 20 · 2016: 19 · 2015: 27 · 2014: 18 · 2013: 10 · 2012: 11
FWCI: 0.59
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Best Practice & Research Clinical Obstetrics & Gynaecology (publishedVersion)
PubMed (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Pure Amsterdam UMC (submittedVersion)
Topics: Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
Keywords: adenomyosis, anti-apoptotic effects, hyperoestrogenism, menorrhagia, dysmenorrhea, endometrial polyps, uterine fibroids, endometrioid carcinoma, hysterectomy, danazol, GnRH analogues, progestogens, surgical treatment
MeSH terms: Adult, Danazol, Endometrial Hyperplasia, Endometriosis, Estrogen Antagonists, Female, Humans, Hysterectomy, Leiomyoma, Gonadotropin-Releasing Hormone, Middle Aged, Polyps, Uterine Diseases, Uterine Neoplasms, Endometrial Neoplasms, Carcinoma, Endometrioid

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Pathology and physiopathology of adenomyosis

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