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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (6): 968-971    DOI: 10.31083/j.ceog.2020.06.5419
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Torsion of a rudimentary uterine horn with multiple leiomyomas in a case of Mayer-Rokitansky-Küster-Hauser syndrome
M.S. Kim1, E.D. Na1, H.C. Kim1, M. Kim1, S.Y. Shin1, M.H. Lee1, *()
1Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
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Abstract  

The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is characterized by congenital hypoplasia or aplasia of the uterus and vaginal agenesis. A 53-year-old woman presented to the emergency department with severe abdominal pain. She was diagnosed with torsion of the right rudimentary uterine horn with multiple leiomyomas with MRKH syndrome. The twisted rudimentary uterine horn and multiple leiomyomas were successfully removed via laparoscopy. MRKH syndrome with uterine horn torsion is uncommon and ours is the first case of torsion in MRKH syndrome treated via a laparoscopic approach. Our report indicates that laparoscopy is ideal for the simultaneous diagnosis and treatment of pelvic masses in MRKH syndrome.

Key words:  Laparoscopy      Leiomyoma      Mayer-Rokitansky-Küster-Hauser syndrome      Torsion     
Submitted:  01 November 2019      Accepted:  20 May 2020      Published:  15 December 2020     
*Corresponding Author(s):  M.H. Lee     E-mail:  yeegen@cha.ac.kr

Cite this article: 

M.S. Kim, E.D. Na, H.C. Kim, M. Kim, S.Y. Shin, M.H. Lee. Torsion of a rudimentary uterine horn with multiple leiomyomas in a case of Mayer-Rokitansky-Küster-Hauser syndrome. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(6): 968-971.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.06.5419     OR     https://ceog.imrpress.com/EN/Y2020/V47/I6/968

Figure 1.  — Magnetic resonance imaging (MRI). (A) Axial T2-weighted images showing a normal right ovary (white arrow). The right rudimentary horn was twisted (white arrowhead), suggesting uterine torsion. (B) Sagittal T2-weighted MRI showing two heterogeneously enhanced circumscribed masses in the pelvis. The absence of the uterus and the upper two-third segment of the vagina was noted (white arrow). MRI, magnetic resonance imaging.

Figure 2.  — Laparoscopic findings. (A) Multiple leiomyomas protruding from the right rudimentary uterine horn. (B) The base of the right rudimentary horn was rotated around 720 degrees clockwise. (C) A left small rudimentary horn may be seen (arrow). (D) All the leiomyomas and the right rudimentary uterine horn and right adnexa were removed.

Table 1  — Case reports on Mayer-Rokitansky-Küster-Hauser syndrome with torsion of the rudimentary horn.
Study Year of publication Study location Age Diagnostic methods Treatment
Yan et al. [10] 2002 China 52 Ultrasound
CT†
Laparotomy
Hysterectomy and bilateral salpingo-oophorectomy
Fletcher et al. [8] 2012 India 28 MRI
Laparotomy
Stalk of the leiomyoma was suture-ligated
Kundo et al. [9] 2014 US 40 Ultrasound
CT
Laparotomy
Right salpingo-oophorectomy, excision of the right and left hemi-uteri, and left salpingectomy
Present 2020 Korea 53 Ultrasound
CT
MRI
Laparoscopy
Right salpingo-oophorectomy, excision of the right rudimentary uterine horn
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