Adenomyosis in a uterine horn of a patient with Mayer-Rokitansky-Kuster-Hauser syndrome

Abstract

A 37-year-old woman with a previous diagnosis of Mayer-Rokitansky-Kuster-Hauser syndrome at 18 years of age was referred from a primary healthcare physician to a gynaecology appointment in our centre. She presented with a 2-year worsening pelvic pain and dyspareunia, symptoms that were previously absent and, at the time, with inadequate relief with oral analgesia. Physical examination showed absent uterine cervix and hypoplastic superior vagina. Transvaginal ultrasound and MRI suggested the presence of an hypoplasic uterus in left rotation. Laparoscopically, two asymmetric rudimentary horns were found, united by a fibrous central band, with an enlarged and congestive left horn. The three structures were removed as a whole. Histopathological examination reported the presence of multiple adenomyotic foci along the full thickness of the left rudimentary horn. The patient had an uneventful postoperative recovery and full remission of her symptoms.

Exosomes: potential diagnostic markers and drug carriers for adenomyosis

“…Some patients with the Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome have been reported to suffer from AM despite their primordial uteri that lack a functional endometrium ( Chun et al, 2013 ; Pinto et al, 2022 ). In such AM patients, the formation of ectopic lesions cannot be explained by the theory of invagination.…”

“…Excessive peristalsis of the uterus causes destruction of the myometrium and facilitates invasion of the endometrial basalis cells, resulting in the formation of AM (Leyendecker et al, 2009;Leyendecker and Wildt, 2011) (Figure 3A). Some patients with the Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome have been reported to suffer from AM despite their primordial uteri that lack a functional endometrium (Chun et al, 2013;Pinto et al, 2022). In such AM patients, the formation of ectopic lesions cannot be explained by the theory of invagination.…”