Conway Francesca, Morosetti Giulia, Camilli Sara, Martire Francesco Giuseppe, Sorrenti Giuseppe, Piccione Emilio, Zupi Errico, Exacoustos Caterina
a Department of Biomedicine and Prevention Obstetrics and Gynecological Clinic , University of Rome "Tor Vergata" , Roma , Italy.
Gynecol Endocrinol. 2019 Mar;35(3):207-210. doi: 10.1080/09513590.2018.1505846. Epub 2018 Nov 1.
Ulipristal acetate (UPA) is used for medical treatment of uterine fibroids. The aim of this study was to describe the effects on painful symptoms and the sonographic uterine modifications in patients with adenomyosis erroneously treated with UPA. This is an observational study on six women affected by adenomyosis and treated with three months of UPA (5 mg/24h). The baseline ultrasonography (US) was not performed at out center nor was the diagnosis of fibroids. The patients came to our attention after the treatment with UPA, prescribed by an external physician. During our post-treatment scan we found aspects of adenomyosis, while no fibroids were detected. Symptoms, myometrial and endometrial ultrasound features were evaluated. All patients reported an increase in pelvic pain. At US evaluation intramyometrial cystic areas were found in all six cases (100%). All patients showed an enhancement of adenomyosis features.The intra-myometrial cysts appeared enlarged and the vascularization enhanced when compared to the images of the pretreatment scan. In patients with adenomyosis treated with UPA due to an erroneous diagnosis of uterine fibroids we observed a worsening of the US features of adenomyosis and of the painful symptoms.
醋酸乌利司他（UPA）用于子宫肌瘤的医学治疗。本研究的目的是描述对因误诊为子宫肌瘤而接受UPA治疗的子宫腺肌病患者疼痛症状和子宫超声改变的影响。这是一项对6名子宫腺肌病患者进行的观察性研究，患者接受了为期三个月的UPA治疗（5毫克/24小时）。我们中心未进行基线超声检查，也未诊断出子宫肌瘤。这些患者在外部医生开具UPA治疗后引起了我们的注意。在我们的治疗后扫描中，我们发现了子宫腺肌病的表现，而未检测到子宫肌瘤。对症状、肌层和子宫内膜的超声特征进行了评估。所有患者均报告盆腔疼痛加重。在超声评估中，所有6例（100%）均发现肌层内囊性区域。所有患者的子宫腺肌病特征均增强。与治疗前扫描图像相比，肌层内囊肿增大，血管化增强。在因误诊为子宫肌瘤而接受UPA治疗的子宫腺肌病患者中，我们观察到子宫腺肌病的超声特征和疼痛症状恶化。
