Identification of Juvenile Cystic Adenomyoma Using High-Resolution Imaging

Juvenile cystic adenomyoma is a rare condition that is often misdiagnosed as a noncommunicating uterine horn or adnexal mass during adolescence.

We describe two patients who presented with dysmenorrhea unresponsive to standard management with oral contraceptives. Both patients were initially misdiagnosed as having endometriotic cysts. Juvenile cystic adenomyoma was suspected on standard pelvic ultrasound scan and subsequent high-resolution three-dimensional ultrasonography. The diagnosis was subsequently confirmed and the lesions successfully treated laparoscopically.

Gynecologists should be aware of the possibility of juvenile cystic adenomyoma in adolescents with dysmenorrhea refractory to medical management. Three-dimensional ultrasonography may provide the resolution necessary to distinguish this rare condition.