The difference between uterine fibroids and adenomyomas

Uterine fibroids and adenomyomas are two different benign uterine tumors. The main differences lie in their pathogenesis, tissue origin and clinical manifestations. Uterine fibroids originate from the proliferation of uterine smooth muscle cells, while adenomyomas are associated with endometriosis into the myometrium.

1. Pathogenesis

Uterine fibroids are hormone-dependent tumors whose growth is stimulated by estrogen and progesterone and are common in women of childbearing age. Adenomyoma is a special type of endometriosis, in which ectopic endometrial tissue invades the myometrium to form localized lesions, which is often accompanied by progressive aggravation of dysmenorrhea.

2. Histological characteristics

Uterine fibroids are composed of spindle-shaped smooth muscle cells with clear borders and a surrounding pseudocapsule. Adenomyoma is composed of endometrial glands and stroma, interwoven with the surrounding myometrium, lacking clear boundaries, and pathological examination shows characteristic endometrial tissue.

3. Imaging performance

In ultrasound examination, uterine fibroids mostly appear as hypoechoic masses surrounded by blood flow signals. Adenomyoma shows thickening of the myometrium with scattered small cysts. The size of the lesions may change before and after menstruation. Magnetic resonance imaging can show spotty high signal in the myometrium.

4. Differences in symptoms

Typical symptoms of uterine fibroids are increased menstrual flow and compression symptoms such as frequent urination. Submucosal fibroids may lead to infertility. Adenomyoma mainly causes secondary dysmenorrhea, and the degree of pain is synchronized with the menstrual cycle. It may be combined with dyspareunia and anal swelling.

5. Treatment principles

Asymptomatic uterine fibroids can be observed, and gonadotropin-releasing hormone agonists such as leuprolide are commonly used for drug treatment. Adenomyoma requires comprehensive treatment. The drug is gestrinone capsules or dienogest tablets. Conservative surgery requires complete removal of the lesion. In severe cases, hysterectomy is required.

It is recommended that regular gynecological examinations be carried out to monitor tumor changes. Patients with anemia need to supplement iron supplements. Those with obvious dysmenorrhea can try hot compress to relieve it. For both types of tumors, long-term use of estrogen-based health products needs to be avoided. Maintaining a regular schedule can help regulate endocrine balance. If abnormal bleeding or pain worsens, you should seek medical evaluation promptly.