Arya Sushila, Burks Heather R
Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
F S Rep. 2021 Feb 10;2(2):166-171. doi: 10.1016/j.xfre.2021.02.002. eCollection 2021 Jun.
To report 2 very rare cases of young women who presented with severe dysmenorrhea and a large cystic lesion in the myometrium, which presented a diagnostic dilemma because they were confused with a Müllerian anomaly.
Case reports and a literature review.
A university-based reproductive endocrinology and infertility clinic in the United States.
An 18- and a 16-year-old nulliparous girl presented with worsening of their longstanding pelvic pain, and imaging study results were suggestive of a Müllerian anomaly.
Abdominal and pelvic computed tomography, transvaginal ultrasonography, pelvic magnetic resonance imaging, operative laparoscopy, and excision of a juvenile cystic adenomyoma (JCA).
Resolution of the pelvic pain and restoration of normal uterine anatomy after appropriate intervention.
Restoration of normal uterine anatomy, which was confirmed by 3-dimensional ultrasonography for case 1; however, case 2 still had a small remnant of JCA postoperatively.
Clinical and radiologic examinations may not be useful in differentiating a Müllerian anomaly from other rare abnormalities like JCA. When in doubt, laparoscopy can assist in diagnosing and treating the condition.
报告2例极为罕见的年轻女性病例，她们表现为严重痛经且子宫肌层有一个大的囊性病变，这造成了诊断困境，因为它们与苗勒管异常相混淆。
病例报告及文献综述。
美国一家大学附属的生殖内分泌与不孕症诊所。
一名18岁和一名16岁的未生育女孩，她们长期存在的盆腔疼痛加重，影像学检查结果提示苗勒管异常。
腹部及盆腔计算机断层扫描、经阴道超声检查、盆腔磁共振成像、手术腹腔镜检查以及切除青少年囊性腺肌瘤（JCA）。
经过适当干预后盆腔疼痛缓解以及子宫解剖结构恢复正常。
病例1经三维超声检查证实子宫解剖结构恢复正常；然而，病例2术后仍有一小部分青少年囊性腺肌瘤残留。
临床和放射学检查可能无法用于区分苗勒管异常与其他罕见异常，如青少年囊性腺肌瘤。如有疑问，腹腔镜检查可协助诊断和治疗该疾病。
