Rare presentation of primary uterine teratoma with congenital unilateral renal agenesis :

Abstract

Introduction: Uterine teratomas are a rare occurrence in gynaecology. The presentation can be elusive due to non-specific signs and symptoms. Its coexistence with Congenital Unilateral Renal Agenesis (CURA) is extremely rare. We report a rare case of extragonadal uterine teratoma with congenital unilateral renal agenesis in a 20-year-old nulliparous patient, who presented with non-specific signs and symptoms at a tertiary care centre, eastern Uganda, and review the literature. Case Presentation: A 20-year-old nulliparous referral from a district hospital presented with a four year history of urinary obstruction that was followed by symptoms of overflow incontinency and hesitancy. She later developed symptoms of abnormal uterine bleeding, dysmenorrhoea, and menorrhagia. On examination, she appeared ill, severely pale, with non-tender bilateral pitting oedema, and blood pressure = 150/ 90 mmHg. She was found to have chronic renal failure with obstructive uropathy and congenital unilateral renal agenesis, and abnormal uterine bleeding with severe anaemia secondary to 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. Conclusion: Although a few cases of uterine teratoma involving corpus, cervix, and fundus have been described, its association with congenital unilateral renal agenesis is rare. Moreover, renal agenesis cases have been mainly reported to coexist with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. We, therefore advise that gynaecologists should be mindful of uterine teratoma as a cause of abnormal uterine bleeding in women of reproductive age and presentation with urinary bladder obstruction and features of uropathy should prompt one to investigate for congenital urinary disorders. Corroborative management with a urologist should be considered. Keywords: Unilateral Renal Agenesis, Uterine Teratoma, Case