Cystic adnexal mass in a 16-year-old female: Ovarian pathology or complication of a Müllerian anomaly?
Unknown ethiology, Mistake in diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Guido Santacana-Laffitte, Lorell Ruiz, Yasmin Pedrogo, Edgar Colon
Am J Case Rep 2013; 14:153-156
Background: Müllerian anomalies encompass a wide variety of malformations in the female genital tract, usually associated with renal and anorectal malformations. Of these anomalies, approximately 11% are uterus didelphys, which occurs when midline fusion of the müllerian ducts is arrested to a variable extent.
Case Report: We report the case of a 16-year-old female with uterine didelphys, jejunal malrotation, hematometra, hematosalpinx, and bilateral subcentimeter homogenous circular cystic-like renal lesions, who initially presented with left lower quadrant abdominal pain, non-bloody vomiting, and a history of irregular menstrual periods. Initial CT was confusing for an adnexal cystic mass, but further imaging disclosed the above müllerian anomalies.
Conclusions: Müllerian anomalies may mimic other, more common, adnexal lesions; thus, adequate evaluation of suspicious cystic adnexal masses with multiple and advanced imaging modalities such as MRI is essential for adequate diagnosis and management.
Keywords: mullerian, uterus didelphys, Hydrometrocolpos, intestinal malrotation, Hematometra, hematosalpynx, renal cysts