Hematometra and Endometrioma accompanying with cervical agenesis and unicornuate uterus

Uterine anomalies have been caused by impairment in the formation, evolution, or defect in the connection of Mullerian bud during the embryonic period. In this study, a case of unicornuate uterus with cervical agenesis is presented.

The patient was a 14-year female with symptoms of backache, pain in the left thigh, nausea, vomiting, and chill, which were started six months ago (no complain of abdominal pain). Sonography was performed and a cystic appendage with a thick wall containing internal eco and somewhat septa solid components appeared in the sinistral pelvis, indicating the sinistral rudimentary horn of the uterus with hematometra (secondary to cervical agenesis). Sonography showed a 32×92 mm twist tubular cystic appendage having an internal eco in left lower quadrant, indicating hydrosalpinx. No left ovary tissue was observed. Hymen was checked and it was imperforate. Due to cervical agenesis, blind vagina and hydrosalpanx, hysterectomy and left salpingectomy surgeries were performed. The pathological answer showed cervical  agenesis and  a unicornuate uterus containing hematometra and hematosalpinx in the left fallopian tube and endometrioma cyst.

Gynecologic problems should be considered in adolescents with initial amenorrhea and abdominal pain.