Rare co-occurrence of a Mullerian cyst and a Gartner's duct cyst

Vaginal cysts of embryological origin are a relatively rare entity. They are often small, solitary and asymptomatic, found incidentally on pelvic examination or imaging. Mullerian cysts are formed by remnants of paramesonephric (Mullerian) ducts, while Gartner's duct cysts are formed by remnants of mesonephric ducts (Wolffian) ducts. These are usually managed expectantly unless they become large and symptomatic. In this case, surgical excision is done. We report the case of a 36-year-old female who presented to the outpatient department of gynaecology with symptoms of mass per vaginum, vaginal discharge and pelvic pain. She did not have any bladder or bowel complaints. Upon pelvic examination, she was found to have a second degree uterovaginal prolapse with a decubitus ulcer and a reducible cystocele. The ulcer had a small opening giving continuous discharge. We suspected this to be a ruptured cyst along the right antero lateral vaginal wall. The patient was admitted for a cyst excision and vaginal hysterectomy. Only intraoperatively, another cyst along the posterior vaginal wall, close to the vault, was discovered. Histopathological examination confirmed the anterolateral one was a Mullerian cyst, unusually accompanied by a Gartner's duct cyst on the posterior vaginal wall.

A rare case of gartner duct cyst presenting as a genital prolapse: a case report

Mullerian cysts are usually small, ranging from 0.1 to 2 cm in diameter. Rarely, they may be enlarged and mistaken for other structures such as uterovaginal prolapse/cystocele/rectocele or urethral diverticulum. Posterior vaginal wall cyst is a very rare case. We present a case of patient presenting with mass coming out from vagina, which, after clinical evaluation and USG, was diagnosed as a Gartner’s cyst. Gartner’s duct cyst is a derivative of Wolffian duct (mesonephric duct) in females. Assessment of the lesion via history taking and pelvic examination is important to confirm both the lesion’s size and location, but appropriate clinical evaluation supported with investigations clinched the diagnosis easily.

Chronology Of Nephrogenic Events In Staged Aborted Human Embryos And Fetuses

Introduction: The description given in various textbooks and literature on development of nephrons in humankidney doesn’t include details of chronology of nephrogenic events at various fetal ages. Though several studieswere reported the knowledge on development of kidney especially on the nephrogenesis are limited. The studiesemphasize the relationship between prenatal development of kidney and adult onset of renal diseases. Hence, anattempt was made in this study to obtain information by observing the serial sections of kidney of embryos andfoetuses of different gestational ages for better understanding of nephrogenic events.Material and methods: Thirty-five aborted embryos and dead fetuses of 5 weeks gestational age to full term wereutilized for this study. The specimens were subjected to routine tissue processing and haematoxylin and eosin(H&E) staining. 5 embryos of less than 8 weeks gestational age were processed as a whole and were seriallysectioned. The histological sections of 5 microns thickness were observed for the time of appearance of variousnephrogenic components and photographed.Results: Differentiating pronephric, mesonephric and metanephric components in different weeks i.e. 05 – 12, 13– 24, 25-36 were studied. In 06 – 12 weeks group a delay in the appearance of Pro and mesonephric, Meso andmetanephric ducts were observed that appeared during the 6th week. Differentiation of other components havenot completed by 6th week when compared with literature. In 13 – 24 weeks also there is delay in corticomedullary differentiation that was observed at 16 wks. at which time the morphologically recognizable Nephronswere also observed. Major part of development occurred between 16-28 weeks instead of 16-24weeks as statedin the literature. Ampulla division continued beyond 24 weeks. Increased number of mature nephrons wereobserved between 24-28 weeks instead of 16-20 wks., nephron arcades were observed during 24-28 weeksinstead of 14-22weeks.Conclusion: Detailed findings of this study could aid the embryologists, neonatologists and nephrologists tounderstand the chronology of nephrogenic events and related consequences of developmental abnormalities.

Descent of mesonephric duct to the final position of the vas deferens in human embryo and fetus / 대한해부학회지

Because the ureter arises from the mesonephric or Wolffian duct (WD), the WD opening should migrate inferiorly along the urogenital sinus or future urethra. However, this process of descent has not been evaluated morphometrically in previous studies and we know little about intermediate morphologies for the descent. In the present work, serial sagittal sections of 15 specimens at gestational age 6–12 weeks and serial horizontal sections of 20 specimens at 6–10 weeks were analyzed. Monitoring of horizontal sections showed that, until 9 weeks, a heart-, lozenge- or oval-shape of the initial urogenital sinus remained in the bladder and urethra. Thus, the future bladder and urethra could not be distinguished by the transverse section or plane. The maximum width of the urogenital sinus or bladder at 6–10 weeks was 0.8 mm, although its supero-inferior length reached 5 mm at 10 weeks. During earlier stages, however, the medial shift of the WD was rather evident. Depending on the extent of upward growth of the bladder smooth muscle, the descent of the vas deferens became evident at 10–12 weeks. Development of the urethral rhabdosphincter likely resulted in the differentiation of urogenital sinus into the urethra and bladder before formation of the bladder neck with 3-layered smooth muscles. Development of the prostate followed these morphological changes, later accelerating the further descent of the WD opening. Because of their close topographical relationships, slight anomalies or accidents of the umbilical cord at 10–12 weeks may have a significant effect on normal anatomy.

Anomalous Left testicular Artery Arising from left Accessory renal Artery and its Clinical implications.

Origin of the Testicular Artery variations were found during routine dissection of abdomen of the middle aged cadaver in the Dept of Anatomy, Govt. Medical College Jammu. On the left side there were two renal arteries, One of them was the main Renal artery which was originating from the anterolateral aspect of abdominal aorta and running to the hilum of the kidney in front of the renal vein The other was the Accessory Renal artery which was originating from anterolateral aspect of aorta 5mm above origin of main renal artery and going to the upper pole of the kidney. The origin of accessory renal artery and main renal artery was 4.2 and 9.2mm below the level of origin of superior mesentric artery. The left testicular artery was originating from the accessory renal artery and crossing the renal artery and the renal vein anteriorly before following its usual course in the posterior abdominal wall. Only one renal artery was seen on the right side arising from the anterolateral aspect of aorta. The right testicular artery originated 52mm below the origin of right renal artery and followed its normal course This anomaly is explained by embryological development of both kidneys and gonads from intermediate mesoderm of mesonephric crest. Further the vasculature of kidneys and gonads is derived from lateral mesonephric branches of dorsal aorta .Even though the condition presents as a silent renal anomaly (Undiagnosed throughout life and revealed only on autopsy) the surgical implications are noteworthy, which too have been highlighted in this report.

Mesonephric adenocarcinoma (endometrioid type) of endocervix with diffuse mesonephric hyperplasia involving cervical wall and myometrium: An unusual case report.

Malignant mesonephric tumors are rare variants of cervical adenocarcinoma, derived from remnants of mesonephric ducts and are associated with mesonephric remnants and/or mesonephric hyperplasia. Few cases have been described in literature. We report an unusual case of cervical mesonephric adenocarcinoma of endometrioid type with squamous morules in association with diffuse mesonephric hyperplasia involving the cervical walls and extending into the myometrium.

Huge uterine-cervical diverticulum mimicking as a cyst.

Here we report an incidental huge uterine-cervical diverticulum from a total abdominal hysterectomy specimen in a perimenopausal woman who presented with acute abdominal pain. The diverticulum was mimicking with various cysts present in the lateral side of the female genital tract. Histopathological examination confirmed this to be a cervical diverticulum with communication to uterine cavity through two different openings. They can attain huge size if left ignored for long duration and present a diagnostic challenge to clinicians, radiologists, as well as pathologists because of its extreme rarity. Therefore, diverticula should also be included as a differential diagnosis. Its histopathological confirmation also highlights that diverticula can present as an acute abdomen, requiring early diagnosis with appropriate timely intervention. Immunohistochemistry CD 10 has also been used to differentiate it from a mesonephric cyst.