Adenomyosis within a didelphys uterus

Case contributed by Dr Ammar Haouimi

Presentation

G3P2, presented with metrorrhagia. Past history of a right ovariectomy for ovarian cyst.

Patient Data

Age: 40 years
Gender: Female

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.

Case Discussion

MRI features of focal adenomyosis within a uterus didelphys (Müllerian duct anomaly class III) with an intramural cystic lesion with fluid-fluid level (focal cystic adenomyosis vs leiomyoma with hemorrhagic degeneration).

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Case information

rID: 70175
Published: 3rd Sep 2019
Last edited: 4th Sep 2019
System: Gynaecology
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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