Background

Vaginal bleeding in the prepubertal child has several etiologies, including structural anomalies, endocrinologic dysfunction, infection, trauma, foreign body, and hematologic disorders.

Case

An 8-year-old premenarcheal girl presented with vaginal bleeding. On ultrasound, she was found to have an intramural hyperechogenic mass in the left uterine fundus. This was biopsied and showed smooth muscle. She was subsequently started on a GnRH agonist to suppress bleeding and has since been followed with serial ultrasounds. We have 6 years of follow-up imaging showing a presumed adenomyoma versus fibroid that has been stable in size.

Summary and Conclusion

We present a novel case of adenomyosis presenting as prepubertal bleeding. Pelvic imaging is prudent to exclude structural etiologies as the cause of prepubertal vaginal bleeding.

中文翻译：

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良性子宫肿瘤是青春期前出血的原因

背景

青春期前儿童的阴道出血有多种病因，包括结构异常、内分泌功能障碍、感染、外伤、异物和血液系统疾病。

案件

一名 8 岁的初潮前女孩出现阴道出血。超声检查发现她的左侧子宫底有壁内高回声肿块。这是活检并显示平滑肌。随后，她开始使用 GnRH 激动剂来抑制出血，并随后进行了一系列超声检查。我们有 6 年的随访影像显示推测的腺肌瘤与大小稳定的肌瘤。

总结与结论

我们提出了一个新的子宫腺肌病病例，表现为青春期前出血。盆腔影像学检查可排除结构性病因作为青春期前阴道出血的原因。