Rare Presentation of Primary Uterine Teratoma with Congenital Unilateral Renal Agenesis: A Case Report

Authors

  • Sanini Sarah Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Busitema University, Uganda.
  • Nteziyaremye Julius Department of Obstetrics and Gynaecology, Mbale Regional Referral Hospital, Uganda. https://orcid.org/0000-0002-6286-2867

Keywords:

unilateral renal agenesis, uterine teratoma, case report

Abstract

Introduction: In gynaecology, uterine teratomas are quite uncommon. The indications and symptoms being vague, its presentation might be difficult to identify. It very seldom coexists with Congenital Unilateral Renal Agenesis (CURA). We describe a rare instance of extragonadal uterine teratoma with congenital unilateral renal agenesis in a 20-year-old nulliparous female who arrived at a tertiary care facility in eastern Uganda with vague signs and symptoms.
Case Presentation: A district hospital referred a 20-year-old nulliparous woman who had a four-year history of urinary blockage and symptoms of overflow incontinence and hesitation. Later, she had menorrhagia, dysmenorrhoea, and irregular uterine bleeding. She was found to be terribly pale and unwell upon inspection, and her blood pressure was measured at 150/90 mmHg. She was discovered to have an abnormal uterine haemorrhage, severe anaemia, congenital unilateral renal agenesis, chronic renal failure with obstructive uropathy, and uterine teratoma. She was managed on repeated blood transfusions and empirical management with antihypertensive drugs, salt and fluid restriction, and antibiotics for chronic renal disease with obstructive uropathy.
She was managed on repeated blood transfusions and empirical management with antihypertensive drugs, salt and fluid restriction, and antibiotics for chronic renal disease with obstructive uropathy.
Conclusion: The association of congenital unilateral renal agenesis with uterine teratomas affecting the corpus, cervix, and fundus is uncommon, despite the few examples of these lesions that have been reported. Additionally, it has been noted that the Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome frequently coexists with instances of renal agenesis. Hence, we encourage gynaecologists to be aware of uterine teratoma as a potential cause of irregular uterine bleeding in women of reproductive age. Additionally, if a patient presents with urinary bladder blockage or other uropathy-related symptoms, one should consider the possibility of congenital urinary diseases. Consideration should be given to collaborative management with a urologist.

How to cite this article:
Sarah S, Julius N. Rare Presentation of Primary Uterine Teratoma with Congenital Unilateral Renal Agenesis: A Case Report. Int J Adv Res Gynaecol Obstet. 2023;1(2):31-39.

References

Gnepp, D.R., Diagnostic Surgical Pathology of the Head and Neck. Book, 2009 2nd Edition.

Ivan Damjanov, B.B.K., and Davor Solter, The Human Teratomas; Experimental and Clinical BiologyThe Human Teratomas: Experimental and Clinical Biology. Humana Press • Clifton, New Jersey, 1983.

Meryam Ben Ameur El Youbi , A.M., Jinane Kharmoum, Imane Aaribi,Saoussane Kharmoum,Abdelilah Bouzoubaa,Hind M’rabti, Saber Boutayeb,Basma El Khannoussi,and Hassan Errihani1, Primary Immature Teratoma of the Uterus Relapsing as Malignant Neuroepithelioma: Case Report and Review of the Literature. Case Reports in Oncological Medicine 2013. 2013.

W. Mann, “Zwei seltene geschwulste des corpus uteri mit bemerkungen zu ihrer entstehungsweise,” Virchows Archiv für Pathologische Anatomie und Physiologie und für Klinische Medizin. (Aus dem Pathologischen Institut des St/idtischen Krank, 1929. 273(3): p. 663-692.

J, P., On dermoid cysts of the ovary. Am J Obstet Gynecol, 1875. 8: p. 404-435.

JENNIFER M PARRINGTON, L.F.W., AND SUSAN POVEY, The origin of ovarian teratomas. Journal of Medical Genetics, 1984.

Thomas Newsom-Davis, D.P., Rebecca Gray, Mohammed Ameen, Iain Lindsay, Kyriakos Papanikolaou, Simon Butler-Manuel, Timothy Christmas, Peter Townsend & Michael Seckl Case report: Malignant teratoma of the uterine corpus. BMC Cancer., 2009. 9(195 ).

Gurda GT, V.C., Yonescu R, Gonzalez-Roibon N, Ellis CL, Batista DA, Netto GJ., Sacrococcygeal teratomas: clinico-pathological characteristics and isochromosome 12p status. Mod Pathol, 2014. 27(4): p. 562-8.

Panesar NK, S.J., Uterine cervical teratoma with divergent neuroepithelial differentiation and development of an oligodendroglioma: report of a case and review of the literature. Ann Diagn Pathol. , 2007. 11(4): p. 293-6.

Cortés J, L.M., Rosselló JJ, Rifá J, Más J, Anglada P, Serra C, Cartaná J, Immature teratoma primary of the uterine cervix. First case report. European Journal of Gynaecological Oncology, 1990. 11(1): p. 37-42.

Thomas Newsom-Davis, D.P., Rebecca Gray,Mohammed Ameen,Iain Lindsay,Kyriakos Papanikolaou,Simon Butler-Manuel,Timothy Christmas,Peter Townsend and Michael Seckl, Case report: Malignant teratoma of the uterine corpus. BMC Cancer., 2009. 9(195).

TAKAHASHI O, S., S ; HATAZAWA, J ; TAKISAWA, J ; SATO, H ; OTA, H ; TANAKA, T, Mature cystic teratoma of the uterine corpus. Acta obstetricia et gynecologica Scandinavica., 1998. 77(9): p. 936-938.

Moore, K.L., Persaud, T.V.N. & Torchia, M.G. (2011). The developing human: clinically oriented embryology (9th ed.). Philadelphia:Saunders. 2011.

PM., B., Sacrococcygeal developmental abnormalities and tumors in children. Perspect Pediatr Pathol., 1984. 8(1): p. 9-56.

LP., D., Gonadal and extragonadal germ cell neoplasia of childhood. Hum Pathol, 1983. 14(6): p. 493-511.

Pereiraab, G.d.C., On human parthenogenesis. Medical Hypotheses, 2017. 106: p. 57-6059.

Linder D, M.B., Hecht F., Parthenogenic origin of benign ovarian teratomas. N Engl J Med., 1975. 292(2): p. 63-6.

LANGLEY, S.P.T.K.S.R.R.F.A., Foetal remnants in the uterus and their relation to other uterine heterotopia. histopathology:International Academy of Pathology, 1979. 3(4).

Simona Stolnicu, E.S., Claudiu V.Molnar, Iulia Barsan, Valeria D’Alfonso,Cosmin Moldovan, Gang Zheng, Brigitte M. Ronnett, and Robert A. Soslow, Mature and immature solid teratomas involving uterine corpus, cervix, and ovary. Int J Gynecol Pathol, 2017 36(3): p. 222-227.

Emmanuel Kamgobe, A.M., Dismas Matovelo, Edgar Ndaboine, Peter Rambau,and Tito Chau, Uterine myometrial mature teratoma presenting as a uterine mass: a review of literature. BMC Clin Pathol., 2016. 16(5).

Lim, S.c.L.Y.s.K.Y.h.L.M.s.L.J.y., Mature teratoma of the uterine cervix with lymphoid hyperplasia. Pathol Int. , 2003. 53(5): p. 327-31.

Wang WC, L.M., Ko JL, Lai YC., Origin of uterine teratoma differs from that of ovarian teratoma: a case of uterine mature cystic teratoma. Int J Gynecol Pathol, 2011. 30(6): p. 544-8.

Gomez-Lobo V, B.W., Khanna PC., Nonpuerperal uterine inversion associated with an immature teratoma of the uterus in an adolescent. Obstet Gynecol. , 2007. 110: p. 491-3.

Tomasino, F.C.F.B.R.M., Mature teratoma of the uterine corpus with thyroid differentiation. Pathology International, 2001.

Physician), L.G.A.F., ACOG Releases Guidelines on Management of Adnexal Masses. 2008. 77(9): p. 1320-1323.

Singh, V., Textbook of Clinical Embryology. Elsevier, 2012.

Schedl, A., Renal abnormalities and their developmental origin. Nature Reviews Genetics, 2007. 8: p. 791-802.

Hillman, A.S.W.a.K.A., Unilateral renal agenesis and the congenital solitary functioning kidney: developmental, genetic and clinical perspectives. BJU INTERNATIONAL, 2006. 99: p. 17-21.

MS., C., Bilateral renal agenesis: clinical implications. South Med J, 1988 3: p. 327-8.

Laurichesse Delmas H, K.M., Doray B, Lémery D,Francannet C, Quistrebert J, Marie C,Perthus Congenital unilateral renal agenesis: Prevalence, prenatal diagnosis, associated anomalies. Data from two birth-defect registries. Birth Defects Res. , 2017 109(15): p. 1204-1211.

DAVIDSON WM, R.G., Bilateral absence of the kidneys and related congenital anomalies. J Pathol Bacteriol. , 1954 68(2): p. 459-74.

.Dursun H1, B.A., Büyükçelik M, Soran M, Noyan A, Anarat A., Associated anomalies in children with congenital solitary functioning kidney. Pediatr Surg Int, 2005. 21(6): p. 456-9.

Rik Westland, M.F.S., Johannes C.F. Ket, Joanna A.E. van Wijk, Unilateral renal agenesis: a systematic review on associated anomalies and renal injury Nephrology Dialysis Transplantation,, 2013. 28(7): p. 1844-1855.

Woldeyes, W.G.a.W., Leiomyoma Arising from Mullerian Remnant, Mimicking Ovarian Tumor in a Woman with MRKH Syndrome and Unilateral Renal Agenesis. Ethiop J Health Sci., 2015. 25(4): p. 381-384.

Muhammad S Ahmed, S.I., Hina Pathan, and Rahila Usman, Unilateral renal agenesis with subseptate uterus and sacrococcygeal teratoma: A unique triad. Indian J Radiol Imaging, 2017. 27(3): p. 298-30.

Joana Gaspar, N.F., Luísa Lobo, Carla Simão, Unilateral renal agenesis and uterine anomalies: how and when can we make this diagnosis? NASCER E CRESCER- BIRTH AND GROWTH MEDICAL JOURNAL, 2017. XXVI(3).

Jr, H.B.S., CONGENITAL ANOMALIES OF THE GENITALIA ASSOCIATED WITH UNILATERAL RENAL AGENESIS WITH PARTICULAR REFERENCE TO TRUE UNICORNUATE UTERUS REPORT OF CASES AND REVIEW OF THE LITERATURE. JAMA Surgery, 1938. 37(4): p. 586-602.

H. Muppala, S.S., J.E. Martin, Unilateral absence of tube and ovary with renal agenesis and associated pyloric stenosis: Communication. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2006. 137.

Vercellini P, D.R., Somigliana E, Viganò P, Lanzani A, Fedele L., Asymmetric lateral distribution of obstructed hemivagina and renal agenesis in women with uterus didelphys: institutional case series and a systematic literature review. Fertil Steril., 2007. 87(4): p. 719-24.

Robbins JB, B.C., Chow LC, Parry JP, Sadowski EA., Müllerian duct anomalies: embryological development, classification, and MRI assessment. J Magn Reson Imaging., 2015. 41(1): p. 1-12.

Papadia A, R.M., Gerbaldo D, Fulcheri E, Ragni N., Mature cystic teratoma of the uterus presenting as an endometrial polyp. Ultrasound Obstet Gynecol., 2007. 29(4): p. 477-8.

Iwanaga S, S.A., Hasuo Y, Yoh S, Miyajima S, Nishimura H, Yakushiji M., Immature teratoma of the uterine fundus. Kurume Med J., 1993. 40(3): p. 153-8.

Ansah-Boateng Y, W.M., Poole DR., Coexistent immature teratoma of the uterus and endometrial adenocarcinoma complicated by gliomatosis peritonei. Gynecol Oncol., 1985 21(1): p. 106-10.

Downloads

Published

2023-07-31