Nadir Bir Pelvik Ağrı Nedeni: Uterus Rudimenter Hornu İçerisinde Dejenere Miyom

Öz

Giriş: Farklı konjenital uterin anomalilerde tedavi seçenekleri önemli ölçüde değişebilmektedir, bu nedenle operasyon öncesi görüntüleme kritik önem arzetmektedir. Olgu Sunumu: Pelvik ağrı ve kusma şikayetleri olan 29 yaşında bayan hasta USG ve pelvik MRG ile değerlendirildi. USG’de pelvik bölgede dejenere miyomu düşündüren hipoekoik kitle saptandı. Bunun üzerine over kitlesi ekartasyonu için pelvik MRG yapıldı ve MRG’de dejenere miyom görüldü. Miyom uterus sağ tarafında rudimenter horn içerisinde idi. Görünüm laparatomi ile doğrulandı. Sonuç: Akut pelvik patolojilerde USG ilk tercih olmakla birlikte konjenital anomalierin tanısında MRG daha üstündür.

Anahtar Kelimeler

• USG, MRG, uterin anomali, dejenere miyom

A Rare Cause of Pelvic Pain: Degenerated Myoma Within a Rudimentary Horn of Unicornuate Uterus

Öz

Introduction: Treatment options for the different congenital uterine abnormalities of the uterus vary considerably; therefore, preoperative imaging plays a crucial role in the management. Case Report: A 29-year-old woman who had pelvic pain and vomiting, were examined with pelvic ultrasound (US) and magnetic resonance imaging (MRI). A hypoechoic pelvic mass was detected via ultrasound. A degenerated myoma was estimated, but to exclude a mass from the right ovary, a pelvic MRI was performed. The degenerated myoma was considered and was located in the rudimentary horn of the right side of the uterus. This appearance was confirmed by laparotomy.Conclusion: Although ultrasound is the first imaging modality for acute pelvic pathologies, magnetic resonance imaging is superior to ultrasound in evaluating the congenital abnormalities of the uterus

Anahtar Kelimeler

• US, MRI, uterine anomaly, degenerated myoma

Kaynakça

1. Golan A, Langer R, Bukovsky I, Caspi E. Congenital anomalies of the mül- lerian system. Fertil Steril, 1989; 51: 747-55.
2. Dähnert W. Obstetric and gynaecologic disorders. In: Radiology Review Manual, 3th edn Baltimore: Williams and Wilkins, 1996; 763.
3. Scarsbrook AF, Moore NR. MRI appearances of Müllerian duct abnorma- lities. Clinical Radiology, 2003; 58: 747-54. [CrossRef]
4. Smolders D, Deckers F, Pouillon M, Vanderheyden T, Vanderheyden J, De Schepper A. Ectopic pregnancy within a rudimentary horn in a case of unicornuate uterus. Eur. Radiol. 2002; 12: 121-4. [CrossRef]
5. Fielding JR. MR imaging of Mullerian anomalies: impact on therapy. Am J Roentgenol 1996; 167: 1491-5. [CrossRef]
6. Brody JM, Koelliker SL, Frishman GN. Unicornuate uterus: imaging ap- pearance, associated anomalies and clinical implications. Am J Roent- genol 1998; 171: 1341-7. [CrossRef]
7. Troiano RN, McCarthy SM. Müllerian Duct Anomalies: Imaging and Cli- nical Issues. Radiology 2004; 233: 19-34. [CrossRef]
8. Pellerito JS, McCarthy SM, Doyle MB, Glickman MG, DeCherney AH. Di- agnosis of uterine anomalies: relative accuracy of MR imaging, endo- vaginal sonography, and hysterosalpingography. Radiology 1992; 183: 795-800.

9. Mirkovic L, Ljubic A, Mirkovic D. Magnetic resonance imaging in the eva- luation of uterus didelphys with obstructed hemivagina and renal age- nesis: a case report. Arch Gynecol Obstet 2006; 274: 246-7. [CrossRef]
10. Caliskan E, Cakiroglu Y, Turkoz E, Corakci A. Leiomyoma on the septum of a septate uterus with double cervix and vaginal septum: a challenge to manage. Fertil Steril 2008; 89: 456. [CrossRef]