Rudimentary Horn Adenomyosis in A 20-Year-Old Patient With Unicornuate Uterus: A Case Report

Elio Junior Feghali, Aimee Daccache, Edwin Feghali, Zaki Sleiman
In: International Journal of Clinical Research · 2022 · vol. 3(1) , pp. 31–36 · doi:10.38179/ijcr.v3i1.87 · W4281624543
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes a 20-year-old woman with a unicornuate uterus and a non-communicating rudimentary horn diagnosed with adenomyosis, successfully treated with laparoscopic removal.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This case report investigated chronic pelvic pain in a 20-year-old woman with a unicornuate uterus and an adjacent, non-communicating rudimentary horn. Using pelvic ultrasound and MRI, the authors identified a large rudimentary horn (10×8 cm) with imaging features suggesting diffuse adenomyosis, and they performed successful laparoscopic removal of the horn followed by specimen extraction using a power morcellation containment system. Pathology confirmed diffuse adenomyosis, and the patient was discharged uneventfully on postoperative day 2, with the authors noting the broader context that obstructive enlargement of a non-communicating horn can lead to hematometra and sometimes adenomyosis. This paper is centrally about endometriosis—no, it is centrally about adenomyosis in the setting of a rudimentary horn of a unicornuate uterus (“Rudimentary Horn Adenomyosis” with diffuse adenomyosis confirmed on pathology).

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Abstract

Background: A unicornuate uterus with a rudimentary horn is a rare Mullerian anomaly with few cases reported in the literature. The symptoms vary depending on the functionality of the endometrial cavity and the presence of an obstruction. Adenomyosis is a disease defined as areas of endometrial glands and stroma present within the myometrium. Reports describing adenomyosis in relation to the Mullerian anomalies are scarce. Case Report: We present a 20-year-old middle eastern woman admitted for chronic pelvic pain and abdominal distension. Pelvic ultrasound revealed a unicornuate uterus with an adjacent mass of 10 x 8 cm. An MRI (Magnetic Resonance Imaging) was performed, and a left unicornuate uterus was demonstrated. On the right side, a large non-communicating rudimentary horn with features suggesting diffuse adenomyosis was found. Laparoscopic removal of the horn was performed successfully, and the extraction of the specimen was made by a power morcellation containment system. The patient was discharged uneventfully the second day after the surgery, and the pathology result confirmed the presence of diffuse adenomyosis. Conclusion: Non-communicating rudimentary horn is a rare finding manifesting as different symptoms in young women. The enlargement of the horn can have obstructive consequences on an active endometrium, and this would lead to the formation of a hematometra and the distension of the cavity, and sometimes adenomyosis.
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Background

A unicornuate uterus with a rudimentary horn is a rare Mullerian anomaly with few cases reported in the literature. The symptoms vary depending on the functionality of the endometrial cavity and the presence of an obstruction. Adenomyosis is a disease defined as areas of endometrial glands and stroma present within the myometrium. Reports describing adenomyosis in relation to the Mullerian anomalies are scarce. Case Report: We present a 20-year-old middle eastern woman admitted for chronic pelvic pain and abdominal distension. Pelvic ultrasound revealed a unicornuate uterus with an adjacent mass of 10 x 8 cm. An MRI (Magnetic Resonance Imaging) was performed, and a left unicornuate uterus was demonstrated. On the right side, a large non-communicating rudimentary horn with features suggesting diffuse adenomyosis was found. Laparoscopic removal of the horn was performed successfully, and the extraction of the specimen was made by a power morcellation containment system. The patient was discharged uneventfully the second day after the surgery, and the pathology result confirmed the presence of diffuse adenomyosis.

Conclusion

Non-communicating rudimentary horn is a rare finding manifesting as different symptoms in young women. The enlargement of the horn can have obstructive consequences on an active endometrium, and this would lead to the formation of a hematometra and the distension of the cavity, and sometimes adenomyosis.

References

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