Laparoscopic removal of an ectopic uterus in a patient with Mayer-Rokitansky-Kuster-Hauser syndrome

Case report and surgical solution for a voluminous uterine leiomyoma in a woman with complicated Mayer-Rokitansky-Küster-Hauser syndrome

OBJECTIVE

To describe a case of leiomyoma in a patient with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome.

DESIGN

Case report.

SETTING

Department of Obstetrics and Gynecology, "Sacra Famiglia Hospital," Novafeltria, Italy.

PATIENT(S)

A 47-year-old woman with MRKH syndrome with lower abdominal pain and pelvic tumescence.

INTERVENTION(S)

Surgery.

MAIN OUTCOME MEASURE(S)

Results on ultrasound scan and magnetic resonance imaging.

RESULT(S)

A pelvic leiomyoma originating from uterine remnant; resection of the mass was performed.

CONCLUSION(S)

Even though magnetic resonance imaging is useful for the diagnosis of leiomyoma of the rudimentary uterus in MRKH syndrome, surgery might be the only definitive solution. Removal of the opposite uterine remnant could also be proposed.

Laparoscopy for differential diagnosis of a pelvic mass in a patient with Mayer-Rokitanski-Küster-Hauser (MRKH) syndrome

OBJECTIVE

To report a rare case of a myoma simulating a pelvic tumor in a patient with Mayer-Rokitanski-Küster-Hauser (MRKH) syndrome. The rudimentary uterus may develop fibroids, and this event can lead to problems in differential diagnosis, especially if no vaginal reconstruction has been carried out.

DESIGN

Case-report.

SETTING

University hospital.

PATIENT(S)

A 39-year-old patient with MRKH syndrome presented with a solid pelvic mass 9 cm in diameter on ultrasound and magnetic resonance imaging that could not be differentiated between fibroid and ovarian tumor.

INTERVENTION(S)

The patient was laparoscopically operated, and a fibroid of the right uterine residual was detected and removed.

RESULT(S)

Histology confirmed a benign leiomyoma.

CONCLUSION(S)

In patients with MRKH syndrome, laparoscopy allows analysis of the origin of a solid pelvic tumor and its removal. Especially in patients without vaginal reconstruction, laparoscopy may be superior to imaging techniques.

Obstructive mullerian anomalies and modern laparoscopic management

STUDY OBJECTIVE

Congenital uterine anomalies are common, although the majority are asymptomatic. When an obstructed system exists, women may present with abdominal pain, or dysmenorrhea. Removal of the obstructed horn may be required in the symptomatic patient. In the past, surgical treatment necessitated a laparotomy.

DESIGN

After preoperative diagnosis and planning using magnetic resonance imaging, laparoscopic removal of the obstructed uterine horn and tube was performed. Morcellation of tissue was used to permit removal through a 15mm port.

SETTING

A central London tertiary referral teaching hospital.

PARTICIPANTS

15 women aged between 13 and 41.

INTERVENTIONS

Between 1999 and 2005, all women underwent laparoscopic removal of the obstructed uterine horn and tube.

MAIN OUTCOME MEASURES

Recovery, hospital stay, length of operation.

RESULTS

All women recovered well, with an operation time of 80 to 300 minutes and an average hospital stay of 5 days.

CONCLUSIONS

A laparoscopic approach is a safe and appropriate technique for the removal of an obstructed uterine horn.

Solid pelvic tumor in a woman with Mayer-Rokitansky-Küstner-Hauser syndrome

A patient with Mayer-Rokitansky-Küstner-Hauser syndrome was operated laparoscopically to remove a solid pelvic tumor with cystic region, originally diagnosed as an ovarian tumor. Histopathological examination of the removed tumor identified it as a leiomyoma of rudimentary uterus.