Recurrent embolic stroke associated with adenomyosis: A single case report and literature review

Isolated distal deep vein thrombosis associated with adenomyosis: Case report and literature review

“…Additionally, 11 cases were directly scheduled for surgical procedures, including eight hysterectomies, two adenomyosis resections, and one supracervical hysterectomy. Although the extended therapeutic use of GnRHa effectively alleviated symptoms in select cases, three patients persisted in experiencing thrombosis or recurrence despite GnRHa treatment 10,15,20 . In such cases, hysterectomy is often considered a final option.…”

“… 26 Limited data are available regarding other types of thrombotic events. To further investigate this association, we conducted a literature search on PubMed using the terms “adenomyosis AND thrombo OR infarction.” This search strategy yielded a total of 22 eligible case or series reports (Table 1 ), including 25 cases (75.7%) of ischemic stroke, 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 6 cases (18.2%) of PE, 22 , 23 and 2 cases (6.1%) of DVT. 24 , 25 The median age of these documented patients was 45 years (range 34–59), with a tendency to experience thrombotic events during menstrual cycles.…”

“…The association between CA125 levels and the severity of adenomyosis remains uncertain. Nonetheless, a pooled analysis of 23 documented stroke cases 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 with CA125 measurements revealed a significant increase in CA125 levels among nine individuals (cases 1, 2, 5, 10, 17–19, 21, 24) experiencing systemic embolism (defined as stroke complicating extremity or organ embolism) and/or recurrent embolism, in contrast to the 14 cases (cases 4, 6–9, 11–16, 20, 23, 25) with isolated and nonrecurrent embolism (see Figure 3 ). This preliminary investigation emphasizes the need for further research to establish the potential value of CA125 in the treatment and monitoring of thrombotic complications associated with adenomyosis.…”

“…Although the extended therapeutic use of GnRHa effectively alleviated symptoms in select cases, three patients persisted in experiencing thrombosis or recurrence despite GnRHa treatment. 10 , 15 , 20 In such cases, hysterectomy is often considered a final option. There was no reported thrombotic recurrence during postoperative follow‐up.…”

“… 2 In 1991, Kupryjańczyk described a case of intravascular endometriosis with thrombosis in a patient diagnosed with adenomyosis. 3 Subsequently, several isolated case reports and case series have documented the occurrence of ischemic stroke 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 and pulmonary embolism (PE) 22 , 23 in patients with adenomyosis, suggesting a possible association with hypercoagulability induced by this disorder. However, there are few reports of cases complicated by isolated deep vein thrombosis (DVT).…”