An unusual form of unicornuate uterus with noncommunicating rudimentary horn: Case report and review of the literature

Background: Congenital uterine anomalies are the most common form of female reproductive tract anomalies. The anomalies are classified into seven major categories in which unicornuate uterus is part of the class II group. Unicornuate uterus with a noncommunicating cavitary rudimentary horn in a young female may present with lower-quadrant tenderness, an abnormal mass, and cyclic or noncyclic pelvic pain that mimics acute appendicitis when localized in the right lower quadrant. Case: This article reports an unusual form of unicornuate uterus in a 14-year-old girl presenting with severe dysmenorrhea and right lower-quadrant tenderness. Abdominal ultrasonography revealed a small uterus and a hypoechogenic solid tubular right pelvic mass. Magnetic resonance imaging (MRI) showed a centrally cystic solid mass in the right pelvic region. Results: The mass was removed via laparotomy and proved to be a rudimentary horn separate from the uterus and bowel lying freely in the right lower quadrant. Conclusions: Uterine anomalies mimicking an acute abdomen as appendicitis must be kept in mind in postmenarchal young patients presenting with cyclic pelvic pain, lower quadrant tenderness, and an abnormal mass. MRI examination as a complement to ultrasound should be the imaging modality used to make the correct diagnosis. In cases of unicornuate uterus with a cavitary communicating or noncommunicating rudimentary horn, surgical removal of the rudimentary horn is indicated to avoid potential complications. © 2012 Mary Ann Liebert, Inc