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Uterine Didelphys, an Uncommon Mullerian Duct Anomaly in a Multiparous Woman with Endometrial Carcinoma

Received: 11 June 2022     Accepted: 24 June 2022     Published: 20 July 2022
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Abstract

Uterine didelphys is a rare deformity with most cases associated with favourable pregnancy outcomes. Uterine carcinoma in such uterine malformation is equally rare with many cases diagnosed late due to failed pre-surgery evaluation associated with routine endometrial biopsy. We report a case of incidental uterine didelphys found during surgery in a 62-year-old para 2 +3, woman with endometriod variant of endometrial carcinoma of the right uterus (grade II, and at least stage III). She, successful, had surgery and currently undergoing adjuvant chemoradiation with no complaint. This case demonstrates the possibility of uterine didelphys in a patient with endometrial cancer even when there has been successful pregnancies and deliveries. Clinicians should be aware of this rare possibility especially in a background of preceding repeated miscarriages. Diligently performed endometrial biopsy can still yield adequate specimen for pre-surgery histological diagnosis despite the documented high failure rate associated with the procedure. Where available, contrast-enhanced magnetic resonance imaging is a useful pre-surgery evaluation test with option of exploratory laparotomy performed to avoid delay in diagnosis and treatment of cancers where this is not available but with high index of suspicion.

Published in International Journal of Clinical Oncology and Cancer Research (Volume 7, Issue 3)
DOI 10.11648/j.ijcocr.20220703.12
Page(s) 60-63
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Uterine Didelphys, Endometrial Cancer, Case Report, Incidental Finding

References
[1] Chandler TM, Machan LS, Cooperberg PL, et al.: Müllerian duct anomalies: from diagnosis to intervention. Br J Radiol. 2009, 82: 1034-42. 10.1259/bjr/99354802.
[2] Jolpin JD and Heilbrun M: Imaging of Müllerian duct anomalies. Top Magn Reson Imaging. 2010, 21: 225-35. 10.1097/GRF.0b013e3181958439.
[3] Rezai S, Bisram P, Alcantara IL, et al.: Didelphys uterus: a case report and review of the literature. Case Rep Obstet Gynecol. 2015: 865821. 10.1155/2015/865821.
[4] Heinonen PK: Uterus Didelphys: A report of 26 cases. Eur J Obstet Gynecol Reprod Biology. 1984, 17: 345. 10.1016/0028-2243(84)90113-8.
[5] John A Rock, Lesley L Breech. Surgery for anomalies of Mullerian ducts, in John A Rock, Hawards W. Jones 111. Editors: TeLinde’s Operative Gynecology, 9th Ed. Lippincott Williams & Wilkins. 200373236. https://openlibrary.org/books/OL8094503M/TeLinde%27s_Operative_Gynecology_%28Te_Linde%27s_Operative_Gynecology%29.
[6] Golan A, Langer R, Wexler S, et al.: Cervical cerclage in pregnant anomalous uterus. Int J Fertil. 1990, 35: 164.
[7] Rezai S, Ligorski C, Hughes A, Fuller PN, Henderson CE (2017: Three Cases of Didelphys Uterus, Including Uterus Didelphys with Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA Syndrome) AKA Herlyn-Werner-Wunderlich Syndrome), with a Systematic Review. Obstet Gynecol Int J. 7: 00241. 10.15406/ogij.2017.07.00241.
[8] The American. Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies, and intrauterine adhesions. The American Fertility Society. Fertil Steril. 1988, 49: 944-955. 10.1016/s0015-0282(16)59942-7.
[9] Raga F., Bauset C., Remohi J., Bonilla-Musoles F., Simón C., Pellicer A: Reproductive impact of congenital Müllerian anomalies. Human Reproduction. 1997, 12: 2277-2281. 10.1093/humrep/12.10.2277.
[10] Magudapathi C: Uterus didelphys with longitudinal vaginal septum: normal deliver—case report. Journal of Clinical Case Reports. 2012, 2: 13. 10.4172/2165-7920.1000194.
[11] Jenabi E, Khazaei S, Bashirian S, Aghababaei S, Matinnia N: Reasons for elective cesarean section on maternal request: a systematic review. J Matern Fetal Neonatal Med. 2020, 33: 3867-3872. 10.1080/14767058.2019.1587407.
[12] Jorgensen, C., & Lusiak, M. (2021: Didelphys Uterus in Pregnancy, an Uncommon Mullerian Duct Anomaly: A Case Report. Clinical practice and cases in emergency medicine, 5, 447-449.
[13] Sarah Tabi, Sanja Kupesic Plavsic (2012: The Role of Three-dimensional Ultrasound in the Assessment of Congenital Uterine Anomalies. Donald School Journal of Ultrasound in Obstetrics and Gynecology. 6: 415-423. 10.5005/jp-journals-10009-1265.
[14] Gkrozou F, Dimakopoulos G, Vrekoussis T, et al.: Hysteroscopy in women with abnormal uterine bleeding: a meta-analysis on four major endometrialpathologies. Arch Gynecol Obstet. 2015, 291: 1347-54.
[15] Emons G, Steiner E, Vordermark D, et al.: Part 2 with recommendations on the therapy and follow-up of endometrial cancer, palliative care, psycho-oncological/psychosocial care/rehabilitation/patient information and healthcare facilities. Geburtshilfe Frauenheilkd. 2018, 78: 1089-1109. 10.1055/a-0715-2964.
[16] Nikki L, Neubauer LJ, Havrilesky BC, et al.: The role of lymphadenectomy in the management of preoperative grade 1 endometrial carcinoma. Gynecologic Oncology. 112: 511-516. 10.1016/j.ygyno.2008.11.012.
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  • APA Style

    Olutosin Alaba Awolude, Olayinka Raphael Kuboye, Sunday Oladimeji Oyerinde. (2022). Uterine Didelphys, an Uncommon Mullerian Duct Anomaly in a Multiparous Woman with Endometrial Carcinoma. International Journal of Clinical Oncology and Cancer Research, 7(3), 60-63. https://doi.org/10.11648/j.ijcocr.20220703.12

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    ACS Style

    Olutosin Alaba Awolude; Olayinka Raphael Kuboye; Sunday Oladimeji Oyerinde. Uterine Didelphys, an Uncommon Mullerian Duct Anomaly in a Multiparous Woman with Endometrial Carcinoma. Int. J. Clin. Oncol. Cancer Res. 2022, 7(3), 60-63. doi: 10.11648/j.ijcocr.20220703.12

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    AMA Style

    Olutosin Alaba Awolude, Olayinka Raphael Kuboye, Sunday Oladimeji Oyerinde. Uterine Didelphys, an Uncommon Mullerian Duct Anomaly in a Multiparous Woman with Endometrial Carcinoma. Int J Clin Oncol Cancer Res. 2022;7(3):60-63. doi: 10.11648/j.ijcocr.20220703.12

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  • @article{10.11648/j.ijcocr.20220703.12,
      author = {Olutosin Alaba Awolude and Olayinka Raphael Kuboye and Sunday Oladimeji Oyerinde},
      title = {Uterine Didelphys, an Uncommon Mullerian Duct Anomaly in a Multiparous Woman with Endometrial Carcinoma},
      journal = {International Journal of Clinical Oncology and Cancer Research},
      volume = {7},
      number = {3},
      pages = {60-63},
      doi = {10.11648/j.ijcocr.20220703.12},
      url = {https://doi.org/10.11648/j.ijcocr.20220703.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20220703.12},
      abstract = {Uterine didelphys is a rare deformity with most cases associated with favourable pregnancy outcomes. Uterine carcinoma in such uterine malformation is equally rare with many cases diagnosed late due to failed pre-surgery evaluation associated with routine endometrial biopsy. We report a case of incidental uterine didelphys found during surgery in a 62-year-old para 2 +3, woman with endometriod variant of endometrial carcinoma of the right uterus (grade II, and at least stage III). She, successful, had surgery and currently undergoing adjuvant chemoradiation with no complaint. This case demonstrates the possibility of uterine didelphys in a patient with endometrial cancer even when there has been successful pregnancies and deliveries. Clinicians should be aware of this rare possibility especially in a background of preceding repeated miscarriages. Diligently performed endometrial biopsy can still yield adequate specimen for pre-surgery histological diagnosis despite the documented high failure rate associated with the procedure. Where available, contrast-enhanced magnetic resonance imaging is a useful pre-surgery evaluation test with option of exploratory laparotomy performed to avoid delay in diagnosis and treatment of cancers where this is not available but with high index of suspicion.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Uterine Didelphys, an Uncommon Mullerian Duct Anomaly in a Multiparous Woman with Endometrial Carcinoma
    AU  - Olutosin Alaba Awolude
    AU  - Olayinka Raphael Kuboye
    AU  - Sunday Oladimeji Oyerinde
    Y1  - 2022/07/20
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    N1  - https://doi.org/10.11648/j.ijcocr.20220703.12
    DO  - 10.11648/j.ijcocr.20220703.12
    T2  - International Journal of Clinical Oncology and Cancer Research
    JF  - International Journal of Clinical Oncology and Cancer Research
    JO  - International Journal of Clinical Oncology and Cancer Research
    SP  - 60
    EP  - 63
    PB  - Science Publishing Group
    SN  - 2578-9511
    UR  - https://doi.org/10.11648/j.ijcocr.20220703.12
    AB  - Uterine didelphys is a rare deformity with most cases associated with favourable pregnancy outcomes. Uterine carcinoma in such uterine malformation is equally rare with many cases diagnosed late due to failed pre-surgery evaluation associated with routine endometrial biopsy. We report a case of incidental uterine didelphys found during surgery in a 62-year-old para 2 +3, woman with endometriod variant of endometrial carcinoma of the right uterus (grade II, and at least stage III). She, successful, had surgery and currently undergoing adjuvant chemoradiation with no complaint. This case demonstrates the possibility of uterine didelphys in a patient with endometrial cancer even when there has been successful pregnancies and deliveries. Clinicians should be aware of this rare possibility especially in a background of preceding repeated miscarriages. Diligently performed endometrial biopsy can still yield adequate specimen for pre-surgery histological diagnosis despite the documented high failure rate associated with the procedure. Where available, contrast-enhanced magnetic resonance imaging is a useful pre-surgery evaluation test with option of exploratory laparotomy performed to avoid delay in diagnosis and treatment of cancers where this is not available but with high index of suspicion.
    VL  - 7
    IS  - 3
    ER  - 

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Author Information
  • Obstetrics and Gynaecology Department, College of Medicine, University of Ibadan, Ibadan, Nigeria

  • Obstetrics and Gynaecology Department, University College Hospital, Ibadan, Nigeria

  • Obstetrics and Gynaecology Department, University College Hospital, Ibadan, Nigeria

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