Endometriosis in a patient with Mayer-Rokitansky-Küster-Hauser syndrome and complete uterine agenesis: evidence to support the theory of coelomic metaplasia.
BACKGROUND
There are many hypotheses regarding the pathogenesis of endometriosis. Most theories, including retrograde menstruation, require the existence of a uterine structure and endometrial tissue. We report endometriosis with the absence of a uterus. This finding supports the theory of coelomic metaplasia.


METHODS
A 20-year-old with Mayer-Rokitansky-Küster-Hauser syndrome presented with increasing pelvic pain and underwent laparoscopy. Uterine, cervical, vaginal, and tubal agenesis was confirmed. Stage I endometriosis was visualized in the posterior cul-de-sac and destroyed. She received medical therapy for 5 years until she represented with pain and underwent another laparoscopy, at which endometriosis was again identified and destroyed.


CONCLUSIONS
This case of endometriosis in a patient with complete uterine agenesis supports the theory of coelomic metaplasia.
Mok-Lin
Evelyn Y
EY
Division of Gynecology, Department of Surgery, Children's Hospital Boston, Boston, Massachusetts, USA.
Wolfberg
Adam
A
Hollinquist
Heidi
H
Laufer
Marc R
MR
D004715:Endometriosis / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008679:Metaplasia; D009095:Mullerian Ducts / Q000196:embryology / Q000473:pathology; D013577:Syndrome; D014599:Uterus / Q000002:abnormalities*; D055815:Young Adult