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Publications

Journal Article Review Epublish

PubMed: 42793753 DOI: 10.3390/diagnostics16182968

Adenomyosis and Uterine Fibroids: Two Distinct Yet Overlapping Clinical Entities.

Diagnostics (Basel) 16(18)

Authors: Giovanni Pecorella, Andrea Morciano, Mykhailo Medvediev, Radmila Sparic, İsmail Bıyık, Gercek Aydin, Giorgio Maria Baldini, Antonio Malvasi, Marta Stojković, Andrea Tinelli

Affiliations

  • Department of Obstetrics and Gynecology, and CERICSAL (CEntro di RIcerca Clinico SALentino), "Veris delli Ponti Hospital", Via Giuseppina Delli Ponti, 73020 Scorrano, LE, Italy.
  • Department of Gynaecology and Obstetrics, Pia Fondazione "Card. G. Panico", 73039 Tricase, LE, Italy.
  • Department of Obstetrics and Gynecology, Dnipro State Medical University, 43100 Dnipro, Ukraine.
  • Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia.
  • Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, Dr Koste Todorovića 26, 11000 Belgrade, Serbia.
  • Department of Obstetrics and Gynecology, Faculty of Medicine, Kütahya Health Sciences University, 43020 Kutahya, Turkey.
  • Department of Obstetrics and Gynecology, Istanbul Health and Technology University Faculty of MedicineIstanbul, Sütlüce Mah. İmrahor Cad. No: 82, 34445 Istanbul, Turkey.
  • Türkiye and Eurofertil IVF Center, Hacı İlyas, Kıbrıs Şehitleri Cd. No:16/A, 16220 Bursa, Turkey.
  • Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (DIM), University of Bari "Aldo Moro", Policlinico of Bari, 70124 Bari, BA, Italy.

Abstract

Adenomyosis and uterine fibroids are among the most common benign uterine disorders in women of reproductive age and represent major causes of abnormal uterine bleeding, pelvic pain, and infertility. Despite their distinct histopathological features, they frequently coexist and share several hormonal and molecular mechanisms, making diagnosis and treatment challenging. This narrative review examines the current evidence on their epidemiology, pathophysiology, clinical presentation, imaging characteristics, reproductive impact, and therapeutic management, with particular attention to the role of imaging in the differential diagnosis and management of coexisting disease. A non-systematic narrative review of the literature was conducted using PubMed/MEDLINE and Scopus. Relevant original studies, systematic reviews, meta-analyses, consensus statements, and clinical guidelines addressing adenomyosis, uterine fibroids, imaging, fertility, and treatment were considered. Additional references were identified through manual screening of the bibliographies of the retrieved articles. Although adenomyosis and uterine fibroids differ in their biological origin and morphological appearance, they commonly present with overlapping symptoms, including heavy menstrual bleeding, dysmenorrhea, chronic pelvic pain, and reproductive dysfunction. Transvaginal ultrasound remains the first-line imaging modality, whereas magnetic resonance imaging is particularly valuable in complex cases, lesion characterization, and preoperative assessment. Accurate imaging phenotyping may help distinguish isolated from coexisting disease and support individualized medical, surgical, or minimally invasive treatment planning. A structured imaging-based approach integrated with clinical findings and reproductive goals may improve disease characterization and support individualized management of adenomyosis and uterine fibroids. Further standardization of imaging criteria and validation of emerging diagnostic technologies may improve patient stratification and treatment selection.

MeSH

Diagnosis, Differential, Fertility, Hemorrhage, Pain, Magnetic Resonance Imaging, Diagnosis, Leiomyoma, Pelvic Pain, Therapeutics, Adenomyosis