Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome with unilateral pulmonary agenesis—a rarity indeed: radiologic review

Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is a congenital condition characterized by agenesis of the uterus and vagina in females with normal ovaries and fallopian tubes, secondary sexual characteristics and 46XX karyotype. They present with primary amenorrhoea. Urinary anomalies, usually renal agenesis and rarely ectopia, occur. Skeletal abnormality can co-exist in about 10% of the patients. Simultaneous pulmonary hypoplasia has been reported very rarely in the literature. The normal external appearance of MRKH syndrome makes it difficult to diagnose until puberty. The purpose of this pictorial essay is to display the structural malformations of this rare disease. The presence of unilateral pulmonary agenesis is extremely rare. The use of invasive diagnostic laparoscopy and ionizing radiation, including intravenous urography or CT scan, has been reported in the literature for diagnosing MRKH. MRI is the mainstay of imaging in evaluating this syndrome, as it is free of radiation, non-invasive and has multiplanar capabilities.