Beyond the Pelvis: Giant Iliopsoas Endometriosis Revealing an Undiagnosed Müllerian Malformation
Year: 2026
Type: article
Abstract: Unicornuate uterus with a non-communicating functional rudimentary horn associated with ipsilateral renal agenesis is a rare congenital Müllerian and Wolffian duct anomaly.We present a rare case of a 35-year-old woman with a known history of endometriosis presenting with a one-year history of cyclical left-sided lumbar pain.Pelvic MRI demonstrated a unicornuate right uterus with a non-communicating functional left rudimentary horn, left hematosalpinx, and ipsilateral renal agenesis on uro-CT.A large retroperitoneal mass measuring 11 cm arising from the left iliopsoas muscle, highly suggestive of a deep infiltrating endometriotic implant, was identified on imaging.Given the high risk of femoral nerve and external iliac vascular injury with surgical excision, a multidisciplinary decision was made to perform percutaneous ultrasound-guided sclerotherapy as a minimally invasive alternative.This case highlights an exceptionally rare association between a unicornuate uterus with a non-communicating functional rudimentary horn, ipsilateral renal agenesis, and giant retroperitoneal endometriosis of the iliopsoas muscle, underscoring the critical role of multimodal imaging in establishing the diagnosis and guiding management in such complex presentations.
Source: Cureus
Institutions: Mohammed V University, Centre Hospitalier Ibn Sina
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7225817051