Fibroids and allied tumours (myoma and adenomyoma) : their pathology, clinical features and surgical treatment . nown to preservetheir connection with the uterus by means of an openchannel, large enough to allow a fertilised ovum to pass. J. B. Hellier drew attention to this point when he wrote: It seems possible, in view of the endometrial diverticulafound in these cases, that an ovum might become embeddedin the uterine wall and so give rise to an ectopic interstitialpregnancy at a point distant from the interstitial part of theoviduct. ^ An interesting histological feature seen in adeno-myom
Fibroids and allied tumours (myoma and adenomyoma) : their pathology, clinical features and surgical treatment . nown to preservetheir connection with the uterus by means of an openchannel, large enough to allow a fertilised ovum to pass. J. B. Hellier drew attention to this point when he wrote: It seems possible, in view of the endometrial diverticulafound in these cases, that an ovum might become embeddedin the uterine wall and so give rise to an ectopic interstitialpregnancy at a point distant from the interstitial part of theoviduct. ^ An interesting histological feature seen in adeno-myoma during pregnancy is the fact that in some instances, ^ The Lancet, January 25, 1913, page 380 ADENOMYOMA chap. but not in all, the * cytogenous tissue around the gland-follicles takes on decidual reaction. Cullen mentions twoinstances in which this occurred, and he sees in the decidualchange a further proof that these islands of mucosa areidentical with the normal uterine mucosa. Whitridge Williams in examining the uterus of apatient entering hospital in a desperate condition, and dying Adenomyoma. Fig. 218.—A case of adenomyoma of the cornu uteri with unruptured tubal gestation.(After Cullens Fig. 66, page 247. By permission.)^ = unrupture(l tubal gestation sac ; M = myoma. The adenomyoma is on the opposite side to thetubal pregnancy. two hours after labour, found that it was the seat of a diffuseadenomyoma, and that the stroma of these islands had beenconverted into typical decidua. This was a proof of themucosal origin, Cullen says, which would certainly tendto convince the most sceptical. Cullen reported a case of his own, in which on the leftside there existed an unruptured tubal pregnancy (seeFig. 218). There was a myoma in the fundus, and an Ill ADENOMYOMA AND PREGNANCY 381 adenomyoma of the right uterine cornu. The stroma ofthe latter growth had in part undergone decidual change, although the adenomyoma was at least 9 cm. away fromthe tubal pregnancy. Boxer
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