Speaker
Description
Background -
A 34 year old female presented to gynaecology OPD of PCMS & RC with chief complaints of heavy menstrual bleeding with severe dysmenorrhea since 3 years with secondary infertility
Obstetric history - P1L1A1 4yrs of non consanguineous married life .
Per abdomen examination – uterus 12 week size ,firm in consistency
Per vaginum examination – uterus is 12-14 weeks size
On investigation - USG report was suggestive of anterior wall subserosal fibroid of 7.5 x 6.5 cm ,
hypoehoic lesion measuring 3.5x 2.3 cm noted in right ovary suggestive of hemorrhagic cyst ?? endometriotic ,ET-6mm
Right ovary appear bulky – 5x4 cm and left ovary 2.7x1.6cm
Rest all investigations are normal
Operative procedure planned - myomectomy F/B hysterectomy with right sided oophorectomy done
Operative findings –
Acutely retroverted uterus
10x10 cm fibroid seen 5cm x 5 cm right complex ovarian cyst seen
Fundus of uterus adhered to rectum
Histopathopathology report of uterus - multiple black clefts seen , 0.3 cm largest diameter .
Specimen received in multiple bits shows myometrial bundles showing interlacing bundles of smooth muscle cells in fascicles appearing in whorling pattern along with endometrial glands and stroma deep in myometrium . the glandular tissue shows proliferative type endometrium,
Features are consistent with adenomyosis uterus
Ovarian sample on gross examination - smooth lobulated .
On cut section – cyst containing brownish fluid ooz out , 4 cm in largest diameter .
Feature suggestive of endometriotic ovary.
