title: Monozygotic twins discordant for vaginal agenesis and bilateral tibial longitudinal deficiency.
abstract: OBJECTIVE
  To report the first case of monozygotic twins with discordant congenital anomalies.
  
  
  METHODS
  Descriptive case report.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A 20-year woman with complete vaginal agenesis (Mayer-Rokitansky-Kuster-Hauser syndrome) and right renal agenesis presented for creation of a neovagina. She had a monozygous twin confirmed by DNA testing using short tandem repeat (STR) loci; the twin had normal mullerian/mesonephric development but isolated bilateral tibial longitudinal deficiency.
  
  
  METHODS
  The complete history, physical, and laboratory data of both the patient and her twin. Also, operative laparoscopy with creation of a neovagina in the patient.
  
  
  METHODS
  Diagnosis and appropriate treatment of Mayer-Rokitansky-Kuster-Hauser syndrome and DNA testing with STR loci for monozygosity.
  
  
  RESULTS
  The surgical resection of the bilateral uterine remnants, creation of a neovagina in the patient, and the demonstration of monozygosity with her twin with bilateral tibial longitudinal deficiency.
  
  
  CONCLUSIONS
  This case report suggests a link between developmental abnormalities of the genital and skeletal system.
authors.affiliation: Department of Obsterics and Gynacology, Division of Reproductive Endocrinology and Infertility, University of Alabama at Birmingham, Birmingham, Alabama 35249-7333, USA. msteinkampf@uabmc.edu
authors.forename: Michael P
authors.initials: MP
authors.lastname: Steinkampf
authors.forename: Sejal P
authors.initials: SP
authors.lastname: Dharia
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Dickerson
mesh_terms: D000328:Adult; D001186:Artificial Limbs; D004200:Diseases in Twins / Q000235:genetics*; D005260:Female; D006801:Humans; D019738:Surgically-Created Structures; D013977:Tibia / Q000002:abnormalities* / Q000601:surgery; D014430:Twins, Monozygotic / Q000235:genetics*; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery