Unicornuate uterus with contralateral rudimentary horn and dorsal pancreatic agenesis

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Infertility

Patient Data

Age: 35 years
Gender: Female

Rightwards deviated unicornuate uterus is seen, measuring approx. 28 x 35 x 46 mm (AP X TD X CC). Endometrial thickness is approx. 3.8 mm. Rudimentary horn is seen on left side with dilated, blood filled endometrial cavity measuring approx. 40 x 42 x 30 mm (AP X TD X CC). No evidence of communication of this endometrial cavity is seen with unicornuate uterus.

Subserosal fibroid measuring approx. 11 x 7 mm is seen at superior aspect of rudimentary horn.

Heterogeneous, irregular soft tissue, measuring approx. 15 x 12 mm with T1 hyperintense areas (likely suggesting hemorrhage) is seen in left adnexa at superior aspect of rudimentary horn. It is closely abutting sigmoid colon. This may represent endometriotic deposit or chronic hemorrhage related to a prior surgery.

Nabothian cyst is seen in cervix.

Left ovary is not well visualized.

Case Discussion

Findings are suggestive of unicornuate uterus with cavitating, non-communicating rudimentary horn (class U4a ESHRE classification) and dorsal agenesis of pancreas.

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