Kim NI, Lee JS, Nam JH. Uterine rupture due to adenomyosis in an adolescent: A case report and review of literature. World J Clin Cases 2023; 11(32): 7888-7894 [PMID: 38073697 DOI: 10.12998/wjcc.v11.i32.7888]
Corresponding Author of This Article
Jong Hee Nam, MD, PhD, Professor, Department of Pathology, Chonnam National University Medical School, 42 Jebong-ro, Gwangju 61469, South Korea. jhnam@jnu.ac.kr
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 16, 2023; 11(32): 7888-7894 Published online Nov 16, 2023. doi: 10.12998/wjcc.v11.i32.7888
Uterine rupture due to adenomyosis in an adolescent: A case report and review of literature
Nah Ihm Kim, Ji Shin Lee, Jong Hee Nam
Nah Ihm Kim, Department of Pathology, Chonnam National University Hospital, Gwangju 61469, South Korea
Ji Shin Lee, Department of Pathology, Chonnam National University Hwasun Hospital, Hwasun 58128, South Korea
Jong Hee Nam, Department of Pathology, Chonnam National University Medical School, Gwangju 61469, South Korea
Author contributions: Kim NI developed the concept of the manuscript and reviewed the literature; Lee JS interpreted the H&E and immunohistochemistry slides; Nam JH contributed to the manuscript drafting; all authors have read and approved the final manuscript.
Supported bythe Chonnam National University Hospital Biomedical Research Institute, No. BCRI22011.
Informed consent statement: We obtained written informed consent from the patient for the publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016) and prepared and revised the manuscript accordingly.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jong Hee Nam, MD, PhD, Professor, Department of Pathology, Chonnam National University Medical School, 42 Jebong-ro, Gwangju 61469, South Korea. jhnam@jnu.ac.kr
Received: August 22, 2023 Peer-review started: August 22, 2023 First decision: September 19, 2023 Revised: September 21, 2023 Accepted: November 8, 2023 Article in press: November 8, 2023 Published online: November 16, 2023
Abstract
BACKGROUND
Uterine rupture is a fatal medical complication with a high mortality rate. Most cases of uterine rupture occur in late pregnancy or during labor and are mainly related to uterine scarring due to previous surgical procedures. Adenomyosis is a possible risk factor for uterine rupture. However, spontaneous uterine rupture due to severe adenomyosis in a non-gravida-teenaged female has not been reported in the literature to date.
CASE SUMMARY
A 16-year-old girl was referred to our hospital for acute abdominal pain and hypovolemic shock with a blood pressure of 90/50 mmHg. Radiologic studies revealed a huge endometrial mass with multiple nodules in the lung, suggesting lung metastasis. The patient underwent an emergency total hysterectomy and wedge resection of the lung nodules. Histologically, the uterus showed diffuse adenomyosis with glandular and stromal dissociation. Lung nodules were endometrioma with massive hemorrhage. Immunohistochemistry demonstrated that the tumor cells were positive for PAX8, ER, and PR expression, leading to a final diagnosis of pulmonary endometriosis and uterine adenomyosis. Following surgery, the patient remains in good condition without recurrence.
CONCLUSION
This is the first case of spontaneous uterine rupture due to adenomyosis in a non-gravida adolescent.
Core Tip: Uterine adenomyosis is rare in adolescents but can lead to massive menorrhagia. Differential diagnoses, early detection, and therapeutic care must be provided to avoid hysterectomy in adolescents.
