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Background. Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a malformation of female genital tract (incidence 1 in 4000 female newborn children). It appears as a result of a disorder in the development of Millerian cannals. Etiology is unknown. Syndrome MRKH is the most frequent cause of primary amenorrhoea (90%). Patients with MRKH have a normal female phenotype, with normal pubic hairness and thelarche, and female karyotype (46XX) followed by primary amenorrhoea. Hormonal status corresponds to healthy women, where the appearance of ovarian tumors and tumors on rudiment parts of uterus is possible. Case report. We presented a case of acute abdomen in a patient with previously not diagnosed MRKH. The diagnosis was done during the operation. Small pelvis and an abdominal part were filled with torquated tumor lump, where ovaries, oviducts, uterus or something resembling rudiment of uterus were not recognized through careful examination. Furthemore, the patient had a short, dead-end vagina. Tumorectomy was done and hystopathological finding showed the presence of vascular leiomyoma. Conclusion. The diagnosis of complex syndromes, such as MRKH, can, despite modern diagnostics, be absent for non-medical and psycho-social reasons. We can expect ovarian and uterine pathology on hypoplastic structures in these patients, as well as in healthy women. Vascular leiomyoma in the patients with MRKH was not found in the available literature.

Background/Aim. Conization is an excisive technique used for both diagnostic and therapeutic purposes. If conizate margins do not show any pathologic changes (negative findings) it is also the only therapeutic measure which should be applied. In case of conizate margins affected by the disease (positive findings), it is necessary not only to assess various parameters but also to decide on a further therapeutic approach. The aim of this study was to determine the incidence of positive findings and its impact on a further optimal therapeutic approach choice. Methods. The data for analyses were retrospectively acquired through an insight into the medical records of the female patients who had undergone conization in the Institute for Gynecology and Obstetrics, Clinical Center of Serbia, within a period from 1995 to 2000. Histopathologic analyses of the bioptic and cervical conizate and reconizate samples were performed in the same institute. The acquired data were analyzed and statistically processed. Results. Within the above mentioned period, a total of 823 conizations were done. In 76 patients, positive findings were determined. The acquired data analysis revealed positive findings decrease during this period, yet with no statistical significance. Higher statistically significant incidence of positive findings, however, was revealed in the patients over 40 years of age. Also, a statistically significantly higher incidence of positive findings was revealed in the apex as compared with other localizations. During the period observed, there was the raise of the number of patients only followed up after the conization without reconization. Also evident was decreasing in the number of histerectomies followed by increasing in the number of reconizations, as the method for reintervention. The most common cause of histerectomy was the apex positive findings with no statistical significance, while of reconization it was positive finding on lateral conizate margins with statistical significance. The association of the apical conizate positive finding with that in the curettements in all the cases was in correlation with positive findings at reintervention. Conclusion. According to the results obtained by analyzing and statistical processing of the acquired data, it could be concluded that reconization does represent a more suitable reintervention in patients with positive conizate findings as compared to histerectomy.