J Menopausal Med.  2013 Dec;19(3):135-138. 10.6118/jmm.2013.19.3.135.

Uterine Adenomyosis Which Developed from Hypoplastic Uterus in Postmenopausal Woman with Mayer-Rokitansky-Kuster-Hauser Syndrome: A Case Report

• Chun S
• Kim YM
• Ji YI

• KMID: 1939537
• DOI: http://doi.org/10.6118/jmm.2013.19.3.135

Abstract

Mayer-Rokitansky-Kuster-Hauser syndrome (MRKHS) is characterized by vaginal agenesis with variable Mullerian duct abnormalities. We report here a case of uterine adenomyosis which developed from a hypoplastic uterus in a patient with MRKHS. A 55-year-old postmenopausal woman visited a university hospital for pelvic mass. She had underwent vaginoplasty via the McIndoe procedure for MRKHS at 15 years of age. Pelvic magnetic resonance imaging showed a 5.4 x 4.8 x 4.7 cm mass suspicious for a uterine myoma. She received total abdominal hysterectomy with bilateral salpingo-oophorectomy, and neither the cervix nor endometrium was found grossly in the surgical specimen. The final histologic diagnosis was uterine adenomyosis.

Keyword

Adenomyosis; Mayer-Rokitansky-Kuster-Hauser syndrome; Uterine adenomyosis

MeSH Terms

Adenomyosis*
Cervix Uteri
Diagnosis
Endometrium
Female
Humans
Hysterectomy
Leiomyoma
Magnetic Resonance Imaging
Middle Aged
Uterus*

Figure

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  Fig. 1 Pelvis magnetic resonance imaging. (A) Uterine mass, coronal view. (B) Uterine mass, sagittal view.

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  Fig. 2 Laparotomic view of the uterine mass.

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  Fig. 3 Gross findings of the specimen. Multinodular uterus shows adenomyoma or myoma like features and the atrophic endometrum as well as the aplastic uterine cervix and vagina. White arrow points to the atrophic ovary and salpinx.

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  Fig. 4 Histologic findings from the resected specimen. (A) Uterine myometrium (H&E, × 200). Microscopically, the uterus shows typical adenomyosis features, such as multifocal atrophic endometrial glands and stroma in the background of proliferating smooth muscle cell bundles. (B) Uterine endometrium (H&E, × 100). The atrophoic endometrium (< 1 mm thickness) is seen in the lower segment of the uterus.

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