Abstract
Accessory and cavitated uterine mass (ACUM) is a rare form of Mullerian anomaly that usually presents in young females with chronic cyclic pelvic pain and/or dysmenorrhea. This clinical entity is often underdiagnosed as it may be mistaken for other differential diagnoses, such as pedunculated myoma or adnexal lesions. Imaging modalities, including ultrasonography and magnetic resonance imaging (MRI), accompanied with relevant and suspicious clinical findings are important tools in making acorrect diagnosis. To date, surgical excision of the mass remains the mainstay of treatment,which provides significant symptom relief. In this study, we present a female adolescent with chronic pelvic pain since menarche who underwent laparotomy with the presumed diagnosis of a left-sided ovarian mass. Retrospective evaluation of pelvic MR images demonstrated that the lesion was in fact an ACUM, which was further confirmed by histopathological examination.
Highlights
Accessory and cavitated uterine mass (ACUM) is a rare newly described Mullerian anomaly, which generally presents with chronic recurrent pelvic pain and/or severe dysmenorrhea in women younger than 30 years of age [1]
ACUMs are difficult to diagnose because of their broad differential diagnosis, which includes rudimentary and cavitated uterine horns such as those found in other uterine malformations, adenomyosis with cystic or degenerated areas, degenerated leiomyomas, and essential and primary dysmenorrhea [4]
We describe a 14-year-old girl presenting with severe pelvic pain since her menarche
Summary
Accessory and cavitated uterine mass (ACUM) is a rare newly described Mullerian anomaly, which generally presents with chronic recurrent pelvic pain and/or severe dysmenorrhea in women younger than 30 years of age [1]. It is an accessory mass at the insertion of the round ligament that is lined by normal endometrium and has a dark-browncolored fluid content [2, 3]. To the best of our knowledge, fewer than 60 cases of ACUM are reported in the literature at the time of writing this paper In this case report, we describe a 14-year-old girl presenting with severe pelvic pain since her menarche. Pelvic magnetic resonance imaging (MRI) showed an apparent adnexal mass, but final histopathological examination was in favor of ACUM
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