Background: Adenomyosis is a benign disease with elevated CA125 level.
Case presentation: We report 3 cases with adenomyosis who developed ischemic stroke during menstruation. The levels of CA125, CA19-9, and D-dimer were elevated, which dropped markedly after the menstrual phase. The development of nonbacterial thrombotic endocarditis (NBTE) and stenosis of the cerebral arteries associated with hypercoagulable state and the hyperviscosity nature of the mucinous protein may be the underlying mechanisms.
Conclusion: Our report suggests that adenomyosis might be a risk factor for ischemic stroke in middle-aged patients.
Keywords: Adenomyosis; CA125; Ischemic stroke; Menstruation; Middle-aged women.