<prompt> Adenomyosis is -Tumor of the uterusMalignant change of the endometrial glands invading the myometriumPre - malignant conditionEctopic endometrial glands within the myometrium  <response>: Ans. is d i.e., Ectopic endometrial glands within the myometrium o Adenomyosis is a benign disease of the uterus characterized by ectopic endometrial glands and stroma within the myometrium.o Most common site : Corpuso Rarely involves one of the walls of uterus or the cervixo Associated conditions:a Leiomyomab Pelvic endometriosisc Endometrial hyperplasiad Endometrial carcinomae Endometrial polypsf Salpingitis isthmica nodosao Microscopic pathophysiology: There is no submucosal layer between the endometrium and myometrium; hence normally the endometrial glands in the basal layer penetrate into the myometrium to some extent. This poses a difficulty in diagnosis of adenomyosis, which is a pathological invasion of the endometrium. Novak and Woodruff criteria: presence of heterotopic endometrium atleast 1 high power field HPF below the basal endometrium. Bensen and Sneedens criteria: Presence of ectopic endometrium glands and stroma at least two standard low power fields 4 mm beneath the myometrial junction, and associated with adjacent myohyperplasia.o Grading of Adenomyosis: Molitors criteria: According to the depth of penetration:i Grade I Inner 13 rd of myometriumii Grade II Middle 13 rd of myometriumiii Grade III: Outer 1 3 rd of myometriumo Grading of Bird et al: Mild: 1-3 glands LPF Moderate: 4-9 glands LPF Severe: 9 glands LPFo Treatment Medical management :Danazol, GnRH agonists Surgical management: Endometrial resection, Uterine artery embolization, MRI - guided focused ultrasound surgery MRIgFUS. 