Endocrine Abstracts

JOINT2506

Background: Delayed puberty in girls is defined as a lack of development of secondary sexual characteristics by the age of 13 years or absence of menarche by the age of 16 years. one of the missed causes of delayed puberty is the condition caused by Mullerian duct anomalies. They are congenital uterine anomalies presented by delayed puberty, infertility, or recurrent miscarriage. Imaging can help to identify patients who can benefit from interventions.

Objectives: This report describes the presentation and hormonal profile of a girl diagnosed with one type of Mullerian duct anomalies. Moreover, it describes the role of MRI pelvis to identify the best intervention for the girl.

Case description: A 16-year-old girl was presented with an attack of acute abdominal pain. There were recurrent cyclic attacks of pelvic pain for a few days which resolved with only analgesics. According to Tanner maturity rating, she has T4 breast development, T4 pubic hair, and T3 axillary hair. Still, she had primary amenorrhea. She had a normal hormonal profile for her age. The conclusive diagnosis was reached by doing MRI pelvis. MRI showed no well-formed uterus, two rudimentary horns with absent cervix and upper vagina.

Conclusions: Mullerian duct anomalies can be a hidden cause of delayed puberty that must be kept in mind when confronting a girl with primary amenorrhea. MRI is the gold standard to diagnose these patients and to put the optimal surgical plans as trials to save fertility.