Delayed diagnosis of Herlyn-Werner-Wunderlich syndrome with diffuse adenomyosis in bilateral horns

Bibliographic Details
Title: Delayed diagnosis of Herlyn-Werner-Wunderlich syndrome with diffuse adenomyosis in bilateral horns
Authors: Roshna Adhikari, Mukesh Paudel, Saroj Sharma, Prabhat Silwal, Sachchu Thapa
Source: Radiology Case Reports, Vol 20, Iss 1, Pp 27-33 (2025)
Publisher Information: Elsevier, 2025.
Publication Year: 2025
Collection: LCC:Medical physics. Medical radiology. Nuclear medicine
Subject Terms: Herlyn-Werner-Wunderlich syndrome, Adenomyosis, Hemivagina, Septoplasty, Medical physics. Medical radiology. Nuclear medicine, R895-920
More Details: The Herlyn-Werner-Wunderlich syndrome is a rare congenital disorder with uterus didelphys, unilateral obstructed hemivagina and ipsilateral renal agenesis, more common on right side. HWW syndrome usually presents at puberty with symptoms like pelvic pain, dysmenorrhea and palpable mass due to the associated hematocolpos or hematometra. Delayed presentation in adulthood as infertility can occur in case of incomplete vaginal septum. Short term complications like pyohematocolpos, pyosalpinx, or pelviperitonitis, and long-term complications, such as endometriosis, increased risk of abortion and infertility can occur. Ultrasound is the initial investigation which demonstrates uterine anomaly, renal agenesis and hematocolpos.Magnetic resonance imaging (MRI) is the imaging modality of choice which helps in confirmation of diagnosis, delineation of vaginal septum, communication between 2 cavities and associated pathologies like adenomyosis better.Vaginal septum resection is the treatment of choice for obstructed hemivagina with hematocolpos.We present you a case of 43 years female with cyclical dysmenorrhea starting few years after menarche with uterine didelphys, left sided vaginal septum with hematocolpos and left renal agenesis. Along with this, diffuse bilateral adenomyosis was present which is uncommonly associated with this anomaly as obstruction is at the level of vagina. Patient was diagnosed late due to misdiagnosis and later treated with septal resection for hematocolpos and with hormonal medications for adenomyosis.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1930-0433
Relation: http://www.sciencedirect.com/science/article/pii/S1930043324010124; https://doaj.org/toc/1930-0433
DOI: 10.1016/j.radcr.2024.09.065
Access URL: https://doaj.org/article/2a76d6f9ab4f4e2a94dea7c37f195a7f
Accession Number: edsdoj.2a76d6f9ab4f4e2a94dea7c37f195a7f
Database: Directory of Open Access Journals
More Details
ISSN:19300433
DOI:10.1016/j.radcr.2024.09.065
Published in:Radiology Case Reports
Language:English