Background: Müllerian remnants are known to exist in the pelvis in females with Müllerian agenesis. These remnants are typically small uterine buds with no connection to the vagina. This article reports a case of an unusual Müllerian remnant in a young female with Müllerian agenesis. Case: A 17-year-old female with known Müllerian agenesis presented with abdominal pain. She was found to have a mass inferior to the liver that was cystic and heterogeneous, and with renal-associated vasculature. Surgical exploration and excision were performed and histologic examination showed the mass to be a hemorrhagic Müllerian remnant cyst. Results: The patient's abdominal pain was resolved postoperatively and she recovered uneventfully. Conclusions: A hemorrhagic Müllerian remnant cyst should be considered in the differential diagnosis of a female with Müllerian agenesis who presents with acute abdominal pain. (J GYNECOL SURG 32:139)
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