Mullerianosis is a rare, benign, and morphologically complex, tumor-like lesion that consists of an organoid structure with normal Müllerian tissue. The diagnosis requires the presence of at least two of the three mullerian tissues: endometriosis, endosalpingiosis, and endocervicosis. There are only less than twenty (20) cases reported in literature. At present there is no published case report of mullerianosis here in the Philippines. This is a case report of a 30-year old Filipino woman who presented predominantly with lower urinary tract symptoms of severe dysuria, hematuria, and lumbar pain and was evaluated for a urologic problem secondary to a posterior bladder mass. Subsequent evaluations revealed the diagnosis of mullerianosis. This is where the interest in mullerianosis sets, its potential to mimic a neoplastic lesion of the urinary tract from clinical and diagnostic viewpoints. The clinical importance to diagnose this case correctly is of grave importance for appropriate management.

Human ; Female ; Dysuria ; Endometriosis ; Fallopian Tube Diseases ; Hematuria ; Lower Urinary Tract Symptoms ; Neoplasms ; Organoids ; Pain ; Philippines ; Urinary Bladder Diseases

OBJECTIVE: Our objective was to compare correctness of diagnosis from phonecamera MMS (Multimedia Messaging Service)-transmitted radiographic images to actual radiographs in confirming diagnosis of surgical conditions.

METHODS: After relaying history anAphysical examination findings through cellphones, 180 radiographs (30 each from General Surgery, Urology, Neurosurgery, Orthopedics, Thoracocardiovascular and Pediatric Surgery) were also captured and transmitted by residents. Images were interpreted at remote sites by surgical specialists who confirmed diagnosis and suggested prompt treatment. Upon arrival at hospital, surgical consultants compared diagnosis with actual radiographic films. Data were analyzed using Binomial Test at the 0.05 level of significance.

RESULTS: Clinical diagnoses were confirmed using 150 conventional radiograms, 28 CT scans and 2 angiograms. Phone-transmitted digital radiographs were compared with actual films viewed. Correctness of diagnosis was: 100 percent (30/30) from Neurosurgery; 93.3 percent (28/30) respectively from General Surgery, Urology, Orthopedics and Thoracocardiovascular Surgery; 90 percent (27/30) from Pediatric Surgery. Phone-transmitted radiographic image interpretations compared with actual radiographic readings showed statistically significant concordance of 96 percent (p = 0.01) for each surgical specialty.

CONCLUSION: Phonecamera MMS images of radiograms, CT scans and angiograms taken by surgical residents in the hospital and transmitted to cellphones of surgeons at remote sites had high correctness of diagnosis. When used to confirm diagnosis from clinical history and physical findings, prompt treatment decisions of different surgical specialty conditions may be made.

Human ; Male ; Female ; Cell Phones ; Telemedicine ; Teleradiology