Presentation
Pelvic pain.
Patient Data
The MRI sequences demonstrate two separated, divergent uterine horns (angle formed by the uterine cavities=100° in this case) with a fundal cleft equal to 4.2 cm. Both, endometrial cavities and cervices are uniformly separate, indicating a uterus didelphys.
The right hemiuterus shows a focal thickening of the endometrium-myometrium junctional zone at anterior fundal region (16 mm), in keeping with focal adenomyosis.
The left hemiuterus shows three intramural leiomyomas, the largest measures (4.5x3.8x3.5 cm).
Both ovaries show normal appearance with minimal effusion in the Douglas pouch.
On abdominal ultrasound both kidneys are of normal size and location.
Case Discussion
MRI features of a uterus didelphys (Müllerian duct anomaly class III) with focal adenomyosis of the right hemiuterus and leiomyomas of the left hemiuterus.