Published online Oct 26, 2021. doi: 10.12998/wjcc.v9.i30.9122
Peer-review started: March 19, 2021
First decision: July 26, 2021
Revised: July 30, 2021
Accepted: September 16, 2021
Article in press: September 16, 2021
Published online: October 26, 2021
Processing time: 215 Days and 19.5 Hours
Accessory and cavitated uterine mass (ACUM) is an uncommon form of connate Müllerian anomaly seen in young and nulliparous women, which presents as chronic periodic pelvic pain and severe dysmenorrhea. The entity is often underdiagnosed due to a broad differential diagnosis, including rudimentary uterine horn, true cavitated adenomyosis and degenerating fibroids.
A 22-year-old woman who presented with severe dysmenorrhea and was initially misdiagnosed with cystic adenomyosis. Gynecological examination and ultrasonography were performed. The patient underwent laparoscopic excision of the mass and histopathological examination confirmed the diagnosis. Postoperatively, the patient did well, with no further dysmenorrhea.
ACUM is difficult to diagnose. A correct diagnosis can be made only after excision and histopathological evaluation. Surgical excision is necessary and can be carried out by laparoscopy.
Core Tip: We present a case of accessory cavitated uterine mass (ACUM) treated with laparoscopic excision. The patient had no further dysmenorrhea after operation. ACUMs are generally underdiagnosed and often reported as juvenile cystic adenomyomas. Early surgical treatment including laparoscopic or open lump removal could prevent prolonged suffering in these young women. ACUM is considered a new variety of Müllerian anomaly.