Abstract
Adenomyosis is an estrogen-dependent disease and ranks among the most common gynecological benign conditions in women of childbearing age. Adenomyosis has been reported to coincide with endometrial hyperplasia, polyps, and even endometrial cancer. This study aims to investigate the incidence of benign, premalignant, and malignant gynecological diseases in women undergoing gynecological surgery for adenomyosis. A retrospective review of medical records collected from January 2021 to May 2023 for surgeries performed at the Obstetrics and Gynecology Hospital affiliated with Fudan University was conducted. Pathology reports of 5648 cases of adenomyosis were studied. The incidence of benign, premalignant, and malignant gynecological pathologies in women with adenomyosis who underwent gynecological surgery were analyzed. The mean age of women with adenomyosis was 49.0 ± 9.0 years. Adenomyosis without other gynecological pathologies was detected in 16.7% of specimens of 5648 patients, while coexistence with one or more gynecological pathologies was present in 82.3% of cases. Additionally, coexistence with two or more gynecological diseases (benign or malignant) was present in 1806 of 5648 patients (31.9%). The most common comorbidities were uterine leiomyoma (57.1%), followed by endometrial cancer (11.8%) and endometriosis (10.7%). Furthermore, we found that women with adenomyosis, leiomyoma, endometriosis, endometrial polyps, or atypical hyperplasia were younger (p < 0.05) compared with adenomyotic patients with malignant tumors. Adenomyosis is a common benign, progressive disease that has garnered increasing attention in recent years. Some studies have suggested a potential association of adenomyosis with several gynecological diseases. Our study shows a high prevalence of endometrial cancer in patients with adenomyosis compared to the general population.