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International Delphi consensus on the histopathological diagnosis of adenomyosis
  1. Tristan McCaughey1,
  2. Samantha S Mooney2,3,
  3. Marsali Newman4,5,
  4. Leonie Constable6,
  5. Charlotte Reddington1,7,
  6. Helen C McNamara1,3,
  7. Martin Healey1,2
  1. 1 Gynaecology 2 Unit (Endometriosis and Pelvic Pain), The Royal Women's Hospital, Parkville, Victoria, Australia
  2. 2 The Julia Argyrou Endometriosis Centre, Epworth Medical Foundation, Richmond, Victoria, Australia
  3. 3 Endosurgery Unit, Mercy Hospital for Women, Heidelberg, Victoria, Australia
  4. 4 Austin Health, Heidelberg, Victoria, Australia
  5. 5 Mercy Hospital for Women, Heidelberg, Victoria, Australia
  6. 6 Melbourne Pathology, Collingwood, Victoria, Australia
  7. 7 Department of Obstetrics, Gynaecology and Newborn Health, The University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Dr Tristan McCaughey, Gynaecology, The Royal Women's Hospital, Parkville, Victoria, Australia; tristan.mccaughey{at}

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Adenomyosis has long been referred to as the ‘elusive’ condition in gynaecology.1 Clinical diagnosis is complicated by symptoms shared with other gynaecological pathologies. Despite being a common part of preoperative workup, ultrasound and MRI lack both sensitivity and specificity.2

Histological assessment of the uterus, while viewed as gold standard, has an inter-pathologist variation as wide as 10–88%.3 The literature reports multiple reasons for this. Diagnosis predominantly relates to the distance of endometrial glands and stroma from the deepest point of the endomyometrial junction. The extent of invasion required for diagnosis, however, is still a matter of debate,4 with no consensus between pathology services. Furthermore, the spread of adenomyosis …

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  • Handling editor Vikram Deshpande.

  • Contributors TM, CR and MH came up with the manuscript idea. LC and MN advised on appropriate topics and content. TM and HM drafted initial manuscript. All authors contributed to editing manuscript.

  • Funding Epworth Researcher Capacity Building Grant from the Epworth Medical Foundation.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.