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Endometrial cancer Double uterus Histopathology Abstract We report a rare case of endometrial carcinoma arisen from both horns of an asymmetrical double uterus. Dr. Yoshiharu Tsukahara, Department of Obstetrics and Gynecology, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390 (Japan) Introduction Although the incidence of a malformed uterus is not so rare, there have been few reports of endometrial carcinoma arising from such a uterus [1–6]. In the literature we could not find any reports on endometrial carcinoma occurring in both horns of a double uterus. The following is quite a rare case of primary adenocarcinoma arisen simultaneously from both horns. Case Report A 61-year-old nulligravid woman with the diagnosis of differentiated adenocarcinoma of the endometrium was referred to our hospital. The physical examination revealed swelling of the left supra-clavicular lymph nodes. The vaginal examination showed a normal uterus and a single external cervical os. The length of the cavum uteri was 7 cm. The pathologic report of a previous series of curet-tage was a well-differentiated papillary adenocarcinoma of the endometrium. All other laboratory data were normal. The intravenous pyelogram showed a bifid ureter at the left and double ureter at the right. The left supraclavicular lymph nodes were resected under local anesthesia. Pathology revealed a metastasized adenocarcinoma. On laparotomy, the uterus (right horn) showed normal size and position. At the left, posterior to the uterus, a protrudent mass (rudimentary uterus), as large as the tip of the thumb, was observed to be attached to the cervix, which had neither attachment of round ligament nor continuity of the cervical canal. Histologically, as shown in figure 1 ‚ the outer side of the mass (left horn) showed a similar structure as the uterine wall, consisting of a covering serosa and thin smooth muscle layer which was demonstrated histochemi-