A Unique Presentation of an Accessory Cavitated Uterine Mass: A Case Report [33G

Abstract

INTRODUCTION: An accessory cavitated uterine mass (ACUM) is defined as an isolated mass lined by functional endometrium and encapsulated by smooth muscle. The typical clinical presentation is age less than 30 years old, severe dysmenorrhea, and chronic pelvic pain. ACUM is considered to be a rare diagnosis. However, this pathology may be less rare and more commonly misdiagnosed than originally believed. METHODS: The clinical case was analyzed and followed with a literature review. RESULTS: The patient is a 28-year-old G2P1011 who presented with shortness of breath and abdominal distention. Imaging revealed a 15 cm x 13.9 cm x 14.7 cm complex pre-sacral mass, severe ascites, and pleural effusion. Her pre-operative diagnosis was Meigs syndrome. Final surgical pathology of the mass confirmed it to be an ACUM. Post-operatively, there was complete resolution of the ascites and pleural effusion. CONCLUSION: A high index of suspicion for ACUM followed by early surgical management is imperative for proper diagnosis and management. Pleural effusion and ascites may be clinical indications of ACUM and should lower one's threshold to consider ACUM on the differential diagnosis.