Persistent Perineal Groove in Late Adolescence with Septate Hymen and Bicornuate Uterus: A Rare Case of Multiple Midline Congenital Anomalies.

Perineal groove (PG) is a rare congenital anomaly characterized by a non-epithelialized sulcus extending from the posterior fourchette to the anus. Although typically diagnosed in infancy and often self-resolving, persistent cases are uncommon. We present a 16-year-old female referred for evaluation of a bicornuate uterus who was found to have persistent perineal groove and a vertical septate hymen. Her history included anterior anus diagnosis in infancy and prior ovarian teratoma. Examination under anesthesia confirmed both anomalies, and she underwent coordinated surgical excision with uncomplicated recovery. This case highlights persistent PG in adolescence and supports a broader caudal developmental field defect as a unifying mechanism for the associated anomalies.