medigraphic.com

2018, Number 1

<< Back Next >>

Rev Med Inst Mex Seguro Soc 2018; 56 (1)

Unicornuate uterus with cavitary noncommunicating rudimentary horn: magnetic resonance characterization

Chamorro-Oscullo JR, Sánchez-Cortázar JA, Gómez-Péreza MG

Language: Spanish
References: 54
Page: 92-97
PDF size: 436.73 Kb.


ABSTRACT

Mullerian duct or paramesonephric anomalies are a group of congenital malformations of the female genital tract that result from the alteration in one or more stages of embryonic development. The prevalence has increased, probably due to the progress of diagnostic imaging methods and the relevance that it has acquired in young women with infertility problems. Magnetic resonance imaging (MRI) is currently the method of choice for characterizing the different types of Mullerian anomalies, its complications and associated pathology. Unicornuate uterus correspond to class II of classification of Mullerian duct anomalies developed by the American Society for Reproductive Medicine. According to this, four subtypes have been identified, each with different clinical implications. A cavitated, non-communicating rudimentary horn in a unicornuate uterus is associated with an increased incidence of gynecological problems and obstetric complications that sometimes threaten the lives of patients, reason why its suspicion, diagnosis and treatment is necessary. We report the case of a patient with infertility in which this subtype of congenital malformation was discovered.


REFERENCES

  1. Santos C, Martín M, Correa RE. Hallazgos en resonancia magnética de las malformaciones uterovaginales: datos imprescindibles previos a una intervención quirúrgica. Rev Chil Obstet Ginecol. 2015;80(1):84-90.

  2. Behr S, Courtier J, Qayyum A. Imaging of Müllerian Duct Anomalies. Radiographics 2012;32:E233-50. doi: 10.1148/rg.326125515.

  3. Cerekja A, Dillon KC, Racanska E, Piazze J. Unicornuate uteri associated with contralateral renal agenesis and ovarian anormalies. J Turk Ger Gynecol Assoc. 2011 Sep 1;12(3):189-91. doi: 10.5152/ jtgga.2011.44. eCollection 2011.

  4. Sajjad Y. Development of the genital ducts and external genitalia in the early human embryo. J Obstet Gynaecol Res. 2010 Oct;36(5):929-37. doi: 10.1111/j.1447-0756.2010.01272.x.

  5. Marten K, Vosshenrich R, Funke M, Obenauer S, Baum F, Grabbe E. MRI in the evaluation of müllerian duct anomalies. Clin Imaging. 2003;27:346-50.

  6. Sen KK, Balasubramaniam D, Kanagaraj V. Magnetic resonance imaging in obstructive Müllerian anomalies. J Hum Reprod Sci. 2013 Apr;6(2):162-4. doi: 10.4103/0974-1208.117167.

  7. Medeiros LR, Rosa DD, Silva FR, Silva BR, Rosa MI. Laparoscopic approach of a unicornuate uterus with noncommunicating rudimentary horns. ISRN Obstet Gynecol. 2011;2011:906138. doi: 10.5402/2011/906138.

  8. Rechberger T, Kulik-Rechberger B. Congenital anomalies of the female reproductive tract-diagnosis and management. Ginekol Pol. 2011;82:137-45.

  9. Junqueira BL, Allen LM, Spitzer RF, Lucco KL, Babyn PS, Doria AS. Müllerian duct anomalies and mimics in children and adolescents: correlative intraoperative assessment with clinical imaging. Radiographics. 2009;29:1085-103.

  10. Acién P, Acién M, Sánchez-Ferrer ML. Mullerian anomalies “without a classification”: from the didelphys- unicollis uterus to the bicervical uterus with or without septate vagina. Fertil Steril. 2009;91:2369-75.

  11. Kaproth-Joslin K, Dogra V. Imaging of Female Infertility A Pictorial Gide to the Hysterosalpingography, Ultrasonography, and Magnetic Resonance Imaging Findings of the Congenital and Acquired Causes of Female Infertility. Radiol Clin N Am. 2013;51:967-81.

  12. Mazouni C, Girard G, Deter R, Haumonte JB, Blanc B, Bretelle F. Diagnosis of Mullerian anomalies in adults: evaluation of practice. Fertil Steril. 2008;89: 219-22.

  13. Yoo R, Yeon J, Youn S, Hyup S. A systematic approach to the magnetic resonance imaging-based differential diagnosis of congenital Müllerian duct anomalies and their mimics. Abdom Imaging. 2015; 40:192-206.

  14. Ambusaidi Q, Jha Ch. Pregnancy in the Rudimentary Uterine Horn. Case report of an unusual presentation. Sultan Qaboos Univerity Med J. 2014;14 (1):134-8.

  15. Thakur S, Sood A, Sharma C. Ruptured noncommunicating rudimentary horn pregnancy at 19 weeks with previous cesarean delivery: a case report. Case Reports in Obstetrics and Gynecology. 2012;2012:4. doi: 10.1155/2012/308476.308476

  16. Kanagal D, Hanumanalu L. Ruptured Rudimentary Horn Pregnancy at 25 Weeks with Previous Vaginal delivery: A Case Report. Case Reports in Obstetrics and Gynecology. 2012; 985076, 4 pag. doi:10.1155/2012/985076

  17. Tailor E, Gomel V. The uterus and fertility. Fertil Steril. 2008;89(1):1-16.

  18. Okonta PI, Abedi H, Ajuyah C, Omo-Aghoja L. Pregnancy in a noncommunicating rudimentary horn of a unicornuate uterus: A case report. Cases J. 2009;2: 6624.

  19. Di Spiezio A, Campo R, Gordts S, Spinelli M, Cosimato C, Tanos V, et al. The comprehensiveness of the ESHRE/ESGE classification of female genital tract congenital anomalies: a systematic review of cases not classified by the AFS system. Human Reproduction. 2015;30(5):1046-58.

  20. Chandler TM, Machan LS, Cooperberg PL, Harris AC, Chang SD. Mullerian duct anomalies: from diagnostic to intervention. Br J Radiol. 2009;82:1034-42.

  21. Troiano RN, McCarthy SM. Müllerian duct anomalies: imaging and clinical issues. Radiology. 2004; 233:19-34.

  22. Kumar S, Satija B, Wadhwa L. Complex Mullerian duct anomaly in a Young female with primary amenorrhoea, infertility, and chronic pelvic pain. J Hum Reprod Sci. 2012;5(3):295-7.

  23. Buntugu K, Ntumy M, Ameh E, Obed S. Rudimentary horn pregnancy: Pre-rupture diagnosis and management. Ghana Med J. 2008;42:92-4.

  24. Reichman D, Laufer MR, Robinson BK. Pregnancy outcomes in unicornuate uteri: a review. Fertil Steril. 2009;90:1886-94.

  25. Jayasinghe Y, Rane A, Stalewski H, Grover S. The presentation and early diagnosis of the rudimentary uterine horn. Obstet Gynecol. 2005;105(6):1456-67.

  26. Khati N, Frazier A, Brindle K. The Unicornuate Uterus and Its Variants. Clinical Presentation, Imaging Findings, and Associated Complications. J Ultrasound Med. 2012;31:319-31.

  27. Leyendecker J, Gorengaut V, Brown J. MR Imaging of Maternal Diseases of the Abdomen and Pelvis during Pregnancy and the Immediate Postpartum Period. RadioGraphics. 2004;24:1301-16.

  28. Li S, Qayyum A, Coakley FV, Hricak H. Association of renal agenesis and Mullerian duct anomalies. J Comput Assist Tomogr. 2000;24(6):829-34.

  29. Parks JK, Dominguez CE. Combined medical and surgical management of rudimentary uterine horn pregnancy. JSLS. 2007;11:119-22.

  30. Goncalves E, Prata J, Ferreira S, Abreu R, Mesquita J, Carvalho A, et al. An Unexpexted Near Term Pregnancy in a Rudimentary Uterine Horn. Case Rep Obstet Gynecol. 2013;307828. http://doi. org/10.1155/2013/307828.

  31. Ombelet W, Verswijvel G, Vanholsbeke C, Schobbens JC. Case report. Unicornuate uterus and ectopic (undescended) ovary. OBGYN. 2011;3(2):131-4.

  32. Jáuregui RA, Alanís J. Estado actual de la clasificación, diagnóstico y tratamiento de las malformaciones müllerianas. Ginecol Obstet Mex. 2013;81:34-46.

  33. Acién P, Acién M, Sánchez-Ferrer M. Complex malformations of the female genital tract. New types and revisión of classification. Hum Reprod. 2004;19:2377-84.

  34. Santacana-Laffitte, Ruiz L, Pedrogo Y, Colon E. Cystic adnexal mass in a 16-year-old female: Ovarian pathology or complication of a Müllerian anomaly? Am J Case Rep. 2013;14:153-6.

  35. Kimberley N, Hutson JM, Southwell BR, Grover SR. Vaginal agenesis, the hymen, and asociated anomalies. J Pediatr Adolesc Gynecol. 2012;25(1):54-8.

  36. Gell JS. Müllerian anomalies. Semin Reprod Med. 2003;21(4):375-88.

  37. Sadow C, Sahni A. Imaging female infertility. Abdom Imaging. 2014;39:92-107.

  38. Lallar M, Nandal R, Sharma D. Unruptured rudimentary horn pregnancy presenting with acute haemoperitoneum with combined intrauterine pregnancy: A case report. Iran J Reprod Med. 2015;13(1):49-52.

  39. Kanno Y, Suzuki T, Nakamura E, Goya K, Nishijima Y, Shinoda M, et al. Successful Term Delivery after Laparoscopic Resection of a Non-communicating Rudimentary Horn in a Patient with a Unicornuate Uterus: A case report. Tokai J Exp Clin Med. 2014;39(2):59-63.

  40. Rackow BW, Arici A. Reproductive performance of women with Müllerian anomalies. Current Opinion in Obstetrics and Gynecology. 2007;19(3):229-37.

  41. Sinha R, Sachan S, Khanna A. Successful outcome in preeclamptic rudimentary horn pregnancy. J Turkish- German Gynecol Assoc. 2011;12:53-5.

  42. Agarwal M, Das A, Singh AS. Dysmenorrhea due to a rare Müllerian anomaly. Niger J Clin Pract. 2011; 14:377-9.

  43. Frontino G, Bianchi S, Ciappina N, Restelli E, Borruto F, Fedele L. The unicornuate uterus with an occult adenomyotic rudimentary horn. J Minim Invasive Gynecol. 2009;16:622-5.

  44. Smolders D, Deckers F, Pouillon M, Vanderheyden T, Vanderheyden J, De Schepper A. Ectopic pregnancy within a rudimentary horn in a case of unicornuate uterus. Eur Radiol. 2002;12:121-4.

  45. Braun P, Grau FV, Pons RM, Enguix DP. Is hysterosalpingography able to diagnose all uterine malformations correctly? A retrospective study. Eur J Radiol. 2005;53:274-9.

  46. Carrasco A, Criales J, Quiroz L. Anomalías Müllerianas uterinas: Aplicaciones de la Resonancia Magnética. Anales de Radiología México. 2008;1:3-7.

  47. Muller GC, Hussain HK, Smith YR, Quint EH, Carlos RC, Jhonson TD, et al. Müllerian duct anomalies: comparison of MRI diagnosis and clinical diagnosis. AJR Am J Roetgenol. 2007;189:1294-302.

  48. Devine K, McCluskey T, Henne M, Armstrong A, Venkatesan A, DeCherney A. Is MRI Sufficient to Diagnose Rudimentary Uterine Horn? A case report and review of the literature. J Minim Invasive Gynecol. 2013;20(4):533-6.

  49. Khanna V, D´Souza J, Tiwari S, Sharma R, Shrivastava A. Case report. Unicornuate uterus with an obstructed rudimentary horn: A report of two cases with an imaging perspective. Medical Journal Armed Forces India. 2013;69(1):78-82.

  50. Marcal L, Nothaft MA, Coelho F, Volpato R, Iyer R. Müllerian duct anomalies: MR imaging. Abdom Imaging. 2011;36:756-64.

  51. Jain N, Goel S. Cystic Adenomyoma simulates uterine malformation: A diagnostic dilema: Case report of two unusual xases. J Hum Reprod Sci. 2012;5: 285-8.

  52. Jain N, Verma R. Imaging diagnosis of accessory and cavitated uterine mass, a rare Mullerian anomaly. Indian J Radiol Imaging. 2014;24:178-81.

  53. Nahum G. Rudimentary uterine horn pregnancy: the 20th century worldwide experience of 588 cases. J Reprod Med. 2002;47(2):151-63.

  54. Khalid E, Jalil S, Anwar T, Nausheen S. Congenital female lower genital tract abnormalities: two years experience in a tertiary care hospital. Park J Surg. 2011;27:44-9.




2020     |     www.medigraphic.com