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双子宫合并宫颈闭锁伴子宫腺肌病、平滑肌瘤及卵巢子宫内膜异位症。病例报告。

Uterus didelphys with cervical agenesis associated with adenomyosis, a leiomyoma and ovarian endometriosis. A case report.

作者信息

Yang Chih-Chun, Tseng Jen-Yu, Chen Pu, Wang Peng-Hui

机构信息

Departments of Obstetrics and Gynecology and of Medical Research, Cardinal Tien Hospital-Hsintien, 362 Chung Cheng Road, Hsintien, Taipei County, 23137 Taiwan, R.O.C.

出版信息

J Reprod Med. 2002 Nov;47(11):936-8.

Abstract

BACKGROUND

Elevated level of serum CA-125 was detected in a 48-year-old woman who was diagnosed with a lateral fusion defect in association with congenital agenesis of the uterine cervix. This unusual case combined two developmental anomalies of the müllerian duct.

CASE REPORT

A 48-year-old woman consulted our outpatient department due to persistent abdominal pain for six months. Bimanual pelvic examination showed absence of the cervix, an anteverted uterus and a 6-cm, left adnexal mass. Ultrasound and computed tomography revealed a uterus didelphys with a 3-cm cystic mass over the right ovary. Serum level of CA-125 was 641.4 U/mL. The patient underwent exploratory laparotomy, and total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathology confirmed adenomyosis and a leiomyoma of the uterus with functional endometrium in conjunction with endometriosis of the right ovary.

CONCLUSION

Multiple müllerian anomalies associated with adenomyosis and endometriosis should be considered in patients presenting with primary amenorrhea. Thorough evaluation, careful planning, fertility preservation and postoperative outcomes should be reviewed.

摘要

背景

在一名48岁女性中检测到血清CA - 125水平升高,该女性被诊断为伴有先天性宫颈发育不全的侧方融合缺陷。这一罕见病例合并了苗勒管的两种发育异常。

病例报告

一名48岁女性因持续腹痛6个月前来我院门诊就诊。双合诊盆腔检查显示宫颈缺如、子宫前倾以及左侧附件区有一个6厘米的肿块。超声和计算机断层扫描显示双子宫,右侧卵巢上方有一个3厘米的囊性肿块。血清CA - 125水平为641.4 U/mL。患者接受了剖腹探查术,并进行了全腹子宫切除术及双侧输卵管卵巢切除术。病理证实为子宫腺肌病、子宫平滑肌瘤伴功能性子宫内膜以及右侧卵巢子宫内膜异位症。

结论

对于原发性闭经的患者,应考虑多种与子宫腺肌病和子宫内膜异位症相关的苗勒管异常。应回顾全面评估、精心规划、生育力保留及术后结果。

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