Adenomyosis within a didelphys uterus
G3P2, presented with metrorrhagia. Past history of a right ovariectomy for ovarian cyst.
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There are two separated, divergent uterine horns with evidence of a large fundal cleft. The endometrial cavities as well as the cervices are uniformly separate in keeping with a uterus didelphys.
Focal thickening of the junctional zone at the corporeofundal region of both uterine horns (18 mm on the right, and 22 mm on the left), indicating focal adenomyosis. There is an intramural mass with fluid-fluid level (blood products) of the posterior cervicoisthmic wall of the left hemiuterus which may correspond to intramural cystic adenomyosis or a leiomyoma with hemorrhagic degeneration
The left ovary shows multiple follicles with mild peritoneal effusion.
Eventration of the mid-pelvic wall with small fluid collection is noted.