The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Mullerian Agenesis: Combined endometrioma and uterus rudimentary horn’s hematometra, a Case Report

Document Type : Case report

Authors
Leili Hafizi 1
Malihe Afiat 2
Elham Moatamedi 3
1 Associate professor, Department of Obstetrics and Gynecology, Neonates and Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Assistant professor, Department of Obstetrics and Gynecology, Neonates and Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/ijogi.2017.8423
Abstract
Introduction: Unicornate uterus is one of the congenital uterus abnormalities in several forms. In this article, we report a rare case of unicornate uterus with non-communicated rudimentary horn and active endometrium combined with the unilateral ovarian endometrioma undistinguished of it.
Case presentation: A 21 years old woman with acute abdominal pain and pelvic mass referred to Imam Reza hospital, Mashhad in 2015. Ultrasonography reported a bicornate uterus and a large cystic mass with size of 12.5×17.5 cm in the right ovary. CBC and tumour markers were normal, only CA-125 was increased. The patient was operated because of the acute abdomen. In the explanatory laparotomy and hysteroscopy, a unicornate uterus with right accessory corn combined to the right ovary was showed that they formed a unique cystic mass contained a chocolate liquid. Rudimentary horn accompanied by the right ovary and falopan tube were resected. Histopathological report confirmed simultaneous endometrioma of the right ovary and hematometra in the rudimentary horn.
Conclusion: Unicornate uterus with non-communicated rudimentary horn and active endometrium may be associated with hematometra and/or endometrioma. The accumulation of chocolate like fluid may lead to destroy of ovary tissue and elimination of rudimentary horn coincide with oophorectomy seemed unavoidable. Therefore, early diagnosis and removal of rudimentary horn can avoid of complication such as endometriosis, oophorectomy and ectopic pregnancy.
Keywords
Endometrioma
Hematometra
Mullerian Agenesis
Unicornate uterus
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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 19, Issue 39
February 2017
Pages 63-67