A bicornuate uterus with a unilateral cornual adenomyosis

BACKGROUND: Few reports have described adenomyosis in association with congenital uterine abnormalities. The authors present a case involving unilateral adenomyosis in a bicornuate uterus. CASE: A 41-year-old married gravida 1, para 1, first became aware that she had a double uterus 14 years earlier at her first prenatal examination when the gestation was identified in the left uterine cavity because of intractable dysmenorrhea. The patient underwent laparoscopically assisted vaginal hysterectomy. Pathological examination confirmed that adenomyosis had affected only the left uterine myometrium. CONCLUSION: The right uterine cornua of a bicornuate uterus served as the control after a pregnancy in the left cornua. The subsequent development of adenomyosis in the left cornua lends weight to theories that suggest pregnancy or other acquired factors may be involved in the pathogenesis and development of adenomyosis.