A case of rudimentary uterine horns with cervical agenesis with intramural fibroid and bilateral endometrioma

Archana Kumari, Ashwini Kumari, Shanti Sah, Mala Mukherjee, Mome Mukherjee, Dipti Anu
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2025 · vol. 14(9) , pp. 3139–3142 · doi:10.18203/2320-1770.ijrcog20252755 · W4413800636
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report details a 35-year-old nulligravida with a rare Mullerian anomaly involving rudimentary uterine horns, cervical agenesis, an intramural fibroid, and bilateral ovarian endometriomas.

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This paper reports a rare case of a 35-year-old nulligravida with a Müllerian anomaly featuring rudimentary uterine horns, cervical agenesis, and vaginal anomalies, along with an intramural fibroid and bilateral ovarian endometriomas. The diagnosis and management described include resection of the Müllerian structures and endometrioma, with the authors noting features consistent with degeneration in the non-functioning horn and suggesting a possible origin for the associated endometrioma using the coelomic metaplasia theory. A limitation is inherent to the case-report design: findings are based on a single patient and do not establish generalizable mechanisms or outcomes. Relevance to endometriosis: the study centers on bilateral ovarian endometrioma in the setting of Müllerian anomaly, directly linking the reported pathology to endometriosis.

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Abstract

The objective of the study was to report a case of rudimentary horns of cervical agenesis with intramural fibroid and bilateral endometrioma. A 35-year-old nulligravida with a rare Mullerian anomaly of uterus, cervix and vagina with coexisting fibroid and endometrioma. A definite diagnosis and resection of Mullerian structure and endometrioma. This reports a rare case of occurrence of benign tumor of mesenchymal origin from a non-functioning uterine horn along with features of degeneration with cervical agenesis along with presence of bilateral ovarian endometrioma reinforcing the possibility of coelomic metaplasia theory of its origin.
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A case of rudimentary uterine horns with cervical agenesis with intramural fibroid and bilateral endometrioma DOI: https://doi.org/10.18203/2320-1770.ijrcog20252755Keywords: Mullerian anomaly, Rudimentary horn, Fibroid, EndometriomaAbstract The objective of the study was to report a case of rudimentary horns of cervical agenesis with intramural fibroid and bilateral endometrioma. A 35-year-old nulligravida with a rare Mullerian anomaly of uterus, cervix and vagina with coexisting fibroid and endometrioma. A definite diagnosis and resection of Mullerian structure and endometrioma. This reports a rare case of occurrence of benign tumor of mesenchymal origin from a non-functioning uterine horn along with features of degeneration with cervical agenesis along with presence of bilateral ovarian endometrioma reinforcing the possibility of coelomic metaplasia theory of its origin. Metrics References Gasner A, Rehman A. Primary Amenorrhea. 2023. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2025. Bortoletto P, Romanski PA, Pfeifer SM. Müllerian Anomalies: Presentation, Diagnosis, and Counseling. Obstet Gynecol. 2024;143(3):369-77. DOI: https://doi.org/10.1097/AOG.0000000000005469 Morcel K, Camborieux L; Programme de Recherches sur les Aplasies Müllériennes; Guerrier D. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Orphanet J Rare Dis. 2007;2:13. DOI: https://doi.org/10.1186/1750-1172-2-13 Tsakos E, Xydias EM, Emmanouil V, Ziogas AC, Tsagias N. Management of a Uterine Fibroid Originating From a Rudimentary Horn in a Patient With Mayer-Rokitansky-Küster-Hauser Syndrome: Report of a Rare Case. Cureus. 2025;17(2):e78598. DOI: https://doi.org/10.7759/cureus.78598 Troncon JK, Zani AC, Vieira AD, Poli-Neto OB, Nogueira AA, Rosa-E-Silva JC. Endometriosis in a patient with mayer-rokitansky-küster-hauser syndrome. Case Rep Obstet Gynecol. 2014;2014:376231. DOI: https://doi.org/10.1155/2014/376231 Miao Y, Wen J, Huang L, Wu J, Zhao Z. Diagnosis and Management of Ovarian Tumor in Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome. Biomed Res Int. 2018;2018:2369430. DOI: https://doi.org/10.1155/2018/2369430 Ramesh B, Shivalingappa, Konda NM, Suryanarayana P. Presence of fibroids in the absence of uterus- Mayer-Rokitansky-Küster-Hauser syndrome with fibroids: a case report. Int J Reprod Contracept Obstet Gynecol. 2023;12(6):1938-40. DOI: https://doi.org/10.18203/2320-1770.ijrcog20231589 Mukherji J, Ganguly RP, Seal SL. Fibroid uterus. In Basics of Gynaecology For Examinees. 3rd edition. 2025;395-421. Nezhat FR, Cathcart AM, Nezhat CH, Nezhat CR. Pathophysiology and Clinical Implications of Ovarian Endometriomas. Obstet Gynecol. 2024;143(6):759-66. DOI: https://doi.org/10.1097/AOG.0000000000005587 .Goluda M, St Gabryś M, Ujec M, Jedryka M, Goluda C. Bicornuate rudimentary uterine horns with functioning endometrium and complete cervical-vaginal agenesis coexisting with ovarian endometriosis: a case report. Fertil Steril. 2006;86(2):462. DOI: https://doi.org/10.1016/j.fertnstert.2005.12.064 Amer S, Bazmi S. HRT in WomenUndergoing Pelvic Clearance for Endometriosis A Case Report and a National Survey. J Clin Med. 2023;12:336. DOI: https://doi.org/10.3390/jcm12010336

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