Medicine (May 2022)

Uterus didelphys complicated with endometrial carcinoma

  • Liang Chen, MD, PhD,
  • Fang Zhang, MD,
  • Yue-bing Ma, MD,
  • Jin-long Chen, MD,
  • Maya Saranathan.

DOI
https://doi.org/10.1097/MD.0000000000029183
Journal volume & issue
Vol. 101, no. 18
p. e29183

Abstract

Read online

Abstract. Rationale:. The incidence of uterine malformations is low (4%–7%). Currently, the National Comprehensive Cancer Network clinical practice guidelines in oncology recommend minimally invasive surgery for early endometrial cancer. Minimally invasive surgery for the treatment of uterine didelphys with endometrial cancer is rare due to the large size of the uterus. To date, only 2 such patients have been reported to have undergone laparoscopy. Whether such patients can be treated with minimally invasive surgery needs to be further explored. Patient concerns:. A 40-year-old woman with uterine didelphys was hospitalized for menorrhagia in the past 2 months. Diagnosis:. Endometrial adenocarcinoma was found in both the uterus and cervix using fractional dilation and curettage. Interventions:. The patient underwent laparoscopic surgery. Postoperative adjuvant radiotherapy and chemotherapy were administered. Outcomes:. There was no sign of recurrence during routine follow-up. Lessons:. The use of a uterine manipulator to lift either side of the uterus could help to expose the narrow ipsilateral para-uterine field. It is difficult to remove the uterus entirely through the vagina, making it necessary to select appropriate cases wherein screening is performed to check if the vagina is loose, and the uterus is of appropriate size. Minimally invasive surgery may be feasible for suitable patients.