Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a spectrum of Müllerian duct anomalies characterized by congenital aplasia of the uterus and of the upper part (2/3) of the vagina, in young women presenting otherwise with normal endocrine status. The ovaries and fallopian tubes are present. It is one of the most common causes of primary amenorrhea and affects at least 1 out of 4500 women. Its penetrance varies, as does the involvement of other organ systems and itcan be isolated (type I) or associated with other malformations (type II). The MRKH syndrome usually remains undetected until the patient presents with primary amenorrhea despite normal development of secondary sexual characteristics, so imaging evaluation can demonstrate in one setting, non invasively, the anomalies in development of genital tract. We report a case of MRKH syndrome in a 16-year-old woman who presented with primary amenorrhea, stressing the role and benefit of imaging in the differential diagnosis.

Leiomyoma is the most common uterine tumor that occurs in more than 20% of women older than 30 years. This tumor presents different types of degenerations and a large variability in MRI imaging patterns. In literature ther is no case reported about leiomyomas spectroscopy. We report a case of 34 year-old woman who was admitted to the hospital for evaluation of an abdominal mass diagnosed at ultrasound. Physical examination revealed abdominal distension and abnormal uterine bleeding. Using abdominal MRI 3 Tesla we were able to determine the presence of a mass near uterine body very close to left ovarian. Laparotomy was performed and it showed a uterine peduncolated lesion. Histological examination proved smooth muscle cells and spindle-shaped cells separated by myxoid materials and ordinary myoma cells. This case report suggests that MR Spectroscopy may be able to allow distinction between benign and malignant lesions. It is important to differentiate leiomyomas from other diseases because of therapeutic treatment. In our case laparoscopic exeresis of the lesion permitted to preserve uterus and Patient's fertility.