A 35-year-old female presents with heavy menstrual bleeding, dysmenorrhea
A 35-year-old female presents with heavy menstrual bleeding, dysmenorrhea, and a pelvic mass. Ultrasound shows an enlarged uterus with heterogeneous myometrial echoes. Which is the most likely diagnosis?
A. Endometrial cancer
B. Uterine leiomyoma
C. Adenomyosis
D. Ovarian cyst
E. Pelvic inflammatory disease
Answer: C
Explanation: Adenomyosis is characterized by the presence of endometrial tissue within the myometrium, causing heavy menstrual bleeding, dysmenorrhea, and uterine enlargement with heterogeneous echoes on ultrasound—distinguishing it from leiomyomas (which have well-defined masses).
