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Persistent mullerian duct syndrome
Divya Renu1, B Ganesh Rao, K Ranganath
1Department of Radiodiagnosis, RAGAVS Diagnostic and Research Centre Pvt Ltd, Sadguru Complex, No.14, 27 Cross, 4 Block West, Jayanagar, Bangalore - 560 011, India.
Abstract:
Persistent Mullerian duct syndrome (PMDS) is a rare form of internal male pseudohermaphroditism in which Mullerian duct derivatives are seen in a male patient. This syndrome is characterized by the persistence of Mullerian duct derivatives (i.e. uterus, cervix, fallopian tubes and upper two thirds of vagina) in a phenotypically and karyotypically male patient. In this article we present the USG and MRI features of a case of PMDS with bilateral cryptorchidism and left sided inguinal hernia, containing the uterus and fallopian tubes.
Insights
Persistent Mullerian duct syndrome (PMDS) is a rare condition where males develop female internal reproductive organs. This case highlights imaging features of PMDS with associated conditions like cryptorchidism and inguinal hernia.
Area of Science:
- Reproductive Endocrinology
- Medical Imaging
- Pediatric Surgery
Background:
- Persistent Mullerian duct syndrome (PMDS) is a rare intersex condition.
- Characterized by the presence of Mullerian duct derivatives (uterus, cervix, fallopian tubes, upper vagina) in a male individual.
- This occurs due to mutations in genes like AMH or AMHR2, affecting Mullerian duct regression.
Observation:
- Presents a case of PMDS in a phenotypically and karyotypically male patient.
- The patient exhibited bilateral cryptorchidism and a left-sided inguinal hernia.
- Imaging studies, including Ultrasound (USG) and Magnetic Resonance Imaging (MRI), were crucial for diagnosis.
Findings:
- USG and MRI clearly visualized the persistent Mullerian structures within the male pelvis.
- Demonstrated the presence of a uterus, cervix, and fallopian tubes.
- Correlated imaging findings with clinical presentation of cryptorchidism and inguinal hernia.
Implications:
- Highlights the importance of imaging in diagnosing PMDS, especially when associated with other congenital anomalies.
- Accurate diagnosis aids in surgical planning for managing cryptorchidism and hernia, while considering the presence of Mullerian remnants.
- Contributes to understanding the spectrum of PMDS and its management in pediatric cases.
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