Adenomyosis: study in a Jewish female population

In a series of 920 hysterectomies, performed during a three-year period at the Gynecological Clinic of Hasharon Hospital, adenomyosis weas found in 89 cases, an incidence of 9.06%. Although this result is in accordance with that reported by other authors, we found a marked difference between the incidence of adenomyosis in the two Jewish female groups under study: the Ashkenazic women (natives of European countries or U.S.A.), and the Sephardic women (natives of Near East countries, Yemen or North Africa); 69.66% of the adenomyosis cases were in the former group as against only 30.34% in the latter. A preoperative diagnosis of adenomyosis was made in 19.10% of the cases. This comparatively high percentage appears to be due to the routine examination of the serum activity of cystine aminopeptidase (CAP) and leucine aminopeptidase (LAP), performed in all patients before operation. Increased values of these enzymes indicate the presence of uterine or ovarian tumoral processes. It is suggested that the diagnosis of adenomyosis must be considered in cases of uterine bleeding, dysmenorrhea and increased CAP and LAP values discovered in multiparous women of around 50 years of age, even when the bimanual examination does not reveal any other pathologic condition.