title: Abscess in adenomyosis mimicking a malignancy in a 54-year-old woman.
abstract: BACKGROUND
  Although there are a few reports describing abscess formation in endometriotic foci no report of abscess formation arising de novo within adenomyosis appears in the literature. Preoperative diagnosis of adenomyosis is frequently difficult because of non-specific signs and symptoms. Synchronous pelvic pathologies such as leiomyoma, endometrial polyp, endometrial hyperplasia, as well as endometrial cancer may cause differential diagnostic problems.
  
  
  METHODS
  A 54-year-old postmenopausal woman complaining of inguinal pain, nightsweats and hot flashes is presented. Radiologic examinations of the pelvis revealed a 95 x 85 mm leiomyoma-like lesion including a 53 x 43 mm cystic space and 9 x 6 mm papillary formation within the uterus raising clinical suspicion of malignancy. A total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed accompanied by a frozen section diagnosis. The frozen section revealed an abscess formation arising in a focus of adenomyosis. The postoperative period of the patient was uneventful.
  
  
  CONCLUSIONS
  The present case, to our knowledge, is the first report representing abscess formation in adenomyosis. Abscess arising within adenomyosis can strongly raise the suspicion of endometrial cancer, particularly if the patient is postmenopausal. If endometrial cancer cannot be ruled out with definitive histopathological diagnosis in the preoperative period, a frozen section becomes mandatory during surgical intervention.
authors.affiliation: Department of Pathology, School of Medicine, Inonu University, Malatya, Turkey. rerguvan@yahoo.com
authors.forename: Rezzan
authors.initials: R
authors.lastname: Erguvan
authors.forename: Mehmet M
authors.initials: MM
authors.lastname: Meydanli
authors.forename: Alpay
authors.initials: A
authors.lastname: Alkan
authors.forename: Mehmet N
authors.initials: MN
authors.lastname: Edali
authors.forename: Hasan
authors.initials: H
authors.lastname: Gokce
authors.forename: Ayşe
authors.initials: A
authors.lastname: Kafkasli
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D019160:Endosonography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007150:Immunohistochemistry; D008875:Middle Aged; D010052:Ovariectomy / Q000379:methods; D017699:Pelvic Pain / Q000175:diagnosis / Q000209:etiology; D017698:Postmenopause; D014591:Uterine Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery