CASE REPORTS   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2014 March;173(3):141-3

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

Endometriosis in a patient with Mayer-Rokitansky-Küster-Hauser syndrome

Savone R., Salvatore G., Di Francesco A.

Unità Complessa di Ostetricia e Ginecologia Lanciano, Chieti, Italia

We report the case of a patient with Mayer-Rokitansky-Küster-Hauser syndrome suffering from right ovarian endometriosis as proof to support the theory of retrograde menstruation as the cause of endometriosis. A 25-year-old woman came to our clinical observation for pelvic pain in primary amenorrhea. The patient underwent a gynecological examination and pelvic ultrasound and confirmed the diagnosis of Mayer-Rokitansky-Küster-Hauser syndrome. Pelvic ultrasonography reveled an absent uterus and vagina, two rudimentary uterine horns, a massive bilobed right paraovarian cystic lesion measuring 12-15 cm, a normal contralateral ovary, normal kidneys and urinary tracts. An operative laparoscopy was performed, during which the absence of the uterus was confirmed. The left uterine horn was adjacent to a normal-appearing ovary and fallopian tube; the right uterine horn was adjacent to a bilobed mass comprising a right ovary endometrioma and a distorted fallopian tube. We proceeded to the cyst incision and drainage of the fluid content, then resection of the ovarian parenchyma and stripping of the cystic wall was performed. Histological examination confirmed the diagnosis of endometriotic lesion. The presence of two rudimentary uterine horns would support the hypothesis of tubal reflux of menstrual blood theory (Sampson) as the pathogenesis of pelvic endometriosis.