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Department of Obstetrics and Gynecology, Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, Shandong 250021, People's Republic of China
Department of Obstetrics and Gynecology, Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, Shandong 250021, People's Republic of China
Department of Obstetrics and Gynecology, Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, Shandong 250021, People's Republic of China
We would like to report a case of endometriosis in a patient with complete uterine
agenesis. A 23-year-old girl was admitted to hospital with primary amenorrhea post
puberty. On pelvic examination, the uterus could not be touched clearly. Trans-abdominal
ultrasound showed a 2.3 cm × 1.9 cm × 1.0 cm hypoechoic nodules (single uterine bud) with no functional endometrium line resonance,
no vaginal gas line resonance was found and the ovaries were in normal size. She was
diagnosed with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome by clinical symptoms,
followed up with endorectal exploration and abdominal ultrasound. Pelvic MRI was not
routinely used in China for the diagnosis of MRKH at that time. During trans-abdominal
sigmoid transplantation for vaginal reconstruction, a purple and brown nodule measured
0.5 cm on the right ovary surface was found which was proved to be an ectopic endometriotic
lesion (old bleeding site possibly from the previous postoperative pathohistologic
analysis, See Fig. 1). As there was no functioning endometrium in the uterine buds, the endometriotic
site might come from metaplasia of the existing epithelium in the ovary which supports
the theory of coelomic metaplasia.
Fig. 1Pathohistologic analysis of the endometriotic lesion on the right ovary (old bleeding
site, H&E, ×200).
