Histopathological Spectrum of Concurrent Uterine Lesions Associated with Adenomyosis: A Retrospective Study at a Referral Tertiary Care Center

Abstract

Adenomyosis is a common gynecological condition characterized by the presence of endometrial glands and stroma within the myometrium. It is often discovered incidentally on histopathological examination and is associated with other uterine pathologies, including leiomyoma, endometrial hyperplasia, and malignancy. This retrospective study aimed to assess uterine histopathological patterns associated with adenomyosis in hysterectomy specimens from patients presenting with abnormal uterine bleeding. The study was conducted in the Department of Pathology at the National Cancer Institute in Sabratha, Libya, from January 2014 to December 2024. Data were retrieved from medical records and histopathology reports of patients who underwent total hysterectomy, with or without adnexal removal, during this period, and were confirmed to have adenomyosis. A total of 122 cases were analyzed using IBM SPSS Statistics version 25.0. The median age was 50.0 years (mean ± SD: 51.26 ± 6.6 years). The most common symptom was abnormal uterine bleeding. A significant correlation (P < 0.001) was found between PMB and synchronous malignant findings. Moreover, estrogen-dependent lesions such as leiomyomas and endometrial hyperplasia can coexist with adenomyosis. It is crucial that more molecular and clinical testing be conducted for a comprehensive evaluation.