Unicornuate uterus with a rudimentary horn, a differential diagnosis of adnexal mass and fibroma: case report

Abstract

Introduction: Uterine anomalies have been caused by impairment in the formation, evolution, or defect in the connection of Mullerian bud during the embryonic period. A unicornuate uterus is one of the congenital abnormalities of the Mullerian duct which is associated with an accessory rudimentary horn in 75% of the cases. This accessory horn may possess functioning endometrium and present with hematometra (retention of blood in the cavity) and become symptomatic. In this study, a case of unicornuate uterus with a rudimentary horn was reported. Case presentation: A 37-year-old MG2L2ab0 woman with a history of 2 term normal vaginal deliveries presented to the gynecology emergency of Imam Reza Hospital, Mashhad, with dysmenorrhea, dyspareunia, and menometrorrhagia. After initial evaluation, the patient underwent laparoscopy with preliminary diagnosis of intraligamentary myoma. The procedure revealed a unicornuate uterus with an accessory rudimentary horn, which was resected along with the adjacent tube. Conclusion: In women presenting with clinical symptoms indicating endometriosis, ectopic pregnancy, or uterus fibroma, congenital anomalies including rudimentary horn should be taken into consideration.

Keywords

• hematometra
• mullerian duct
• rudimentary horn