Congenital genitourinary malformation in a woman with three primary gynaecological tumours: synchronous findings never before described.

To cite: Vale-Fernandes E, Monteiro C, Carvalho L, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2015213840 DESCRIPTION The authors describe the case of a 69-year-old nulliparous White woman without any relevant personal or family history who, in the course of the study of a progressive increase in abdominal circumference, underwent an abdominal-pelvic ultrasound, which revealed a large pelvic mass, lateralised to the left, suggestive of fibroid, and a single left kidney. The pelvic CT confirmed the ultrasonographic findings and showed left ureterohydronephrosis with signs of nephropathy in relation to extrinsic compression (figures 1 and 2). Renal function was normal. The patient underwent exploratory laparotomy, and a bulky lobulated pelvic mass occupying the entire pelvis, extending cranially to the umbilical plan, apparently suggestive of a large uterine or ovarian fibroid, was visualised. Washed peritoneal fluid (ascites did not exist) and debulking surgery with total hysterectomy and bilateral adnexectomy were performed (figure 3). The cytology was negative for malignant cells and histological results revealed a fibroid of the left ovary of about 2500 g, right unicornuate uterus with rudimentary left horn, both with complex endometrial hyperplasia with atypia, and bilateral fallopian tube in situ serous carcinoma (serous tubal intraepithelial carcinoma with the p53 signature sparing the fimbriated end of the fallopian tube). As per advice from the multidisciplinary group, no complementary treatment was provided. The patient was asymptomatic through 2-year follow-up.