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Accessory cavitated uterine mass (ACUM) as a miniature uterine anomaly causing severe lateralized dysmenorrhea: case series
, 21
Affiliations- Gynecology and Obstetrics Clinical Hospital of Poznan University of Medical Sciences, Poland
- Division of Gynecology, Poznan University of Medical Sciences, Poland
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Abstract
Objectives: Our study aimed to retrospectively analyse and present the clinical course of accessory cavitated uterine mass (ACUM), a rarely diagnosed uterine malformation.
Material and methods: The study group comprised 5 adolescents and young adult women that were treated in the Division of Gynecology, Clinical Hospital of Obstetrics and Gynecology of Poznan University of Medical Sciences, between October 2017 and August 2022. Patients’ age at diagnosis of ACUM ranged from 14.1 to 27.5 (mean 21.4) years. All patients complained of severe dysmenorrhea with significant lateralisation of the pain.
Results: Pelvic ultrasound (US) followed by pelvic magnetic resonance imaging (MRI) revealed the presence of a small cystic lesion surrounded by a ring of myometrium within or in connection with the regular uterine body. In four patients (80%), the lesion was on the right side, and in one patient (20%) on the left side. The volume of the ACUM cavity ranged from 0.04 to 2.4 (mean 0.8) cm3. Laparoscopic excision of ACUM, located near the uterine attachment of the round ligament, was performed in all five cases and resulted in the complete resolution of symptoms. None of the patients was diagnosed with adenomyosis or pelvic endometriosis.
Conclusions: ACUM is a small, surgically correctable cause of severe dysmenorrhea in young females with an otherwise normal uterus. The lateralisation of the menstrual pain should prompt the search for this malformation with imaging techniques (US, MRI). ACUM laparoscopic excision results in complete relief of symptoms. ACUM is not associated with pelvic endometriosis.
Abstract
Objectives: Our study aimed to retrospectively analyse and present the clinical course of accessory cavitated uterine mass (ACUM), a rarely diagnosed uterine malformation.
Material and methods: The study group comprised 5 adolescents and young adult women that were treated in the Division of Gynecology, Clinical Hospital of Obstetrics and Gynecology of Poznan University of Medical Sciences, between October 2017 and August 2022. Patients’ age at diagnosis of ACUM ranged from 14.1 to 27.5 (mean 21.4) years. All patients complained of severe dysmenorrhea with significant lateralisation of the pain.
Results: Pelvic ultrasound (US) followed by pelvic magnetic resonance imaging (MRI) revealed the presence of a small cystic lesion surrounded by a ring of myometrium within or in connection with the regular uterine body. In four patients (80%), the lesion was on the right side, and in one patient (20%) on the left side. The volume of the ACUM cavity ranged from 0.04 to 2.4 (mean 0.8) cm3. Laparoscopic excision of ACUM, located near the uterine attachment of the round ligament, was performed in all five cases and resulted in the complete resolution of symptoms. None of the patients was diagnosed with adenomyosis or pelvic endometriosis.
Conclusions: ACUM is a small, surgically correctable cause of severe dysmenorrhea in young females with an otherwise normal uterus. The lateralisation of the menstrual pain should prompt the search for this malformation with imaging techniques (US, MRI). ACUM laparoscopic excision results in complete relief of symptoms. ACUM is not associated with pelvic endometriosis.
Keywords
accessory cavitated uterine mass; accessory cavitated uterine malformation; ACUM; dysmenorrhea
About this articleTitle
Accessory cavitated uterine mass (ACUM) as a miniature uterine anomaly causing severe lateralized dysmenorrhea: case series
Journal
Issue
Article type
Research paper
Pages
907-912
Published online
2023-07-10
Page views
648
Article views/downloads
691
DOI
Pubmed
Bibliographic record
Ginekol Pol 2023;94(11):907-912.
Keywords
accessory cavitated uterine mass
accessory cavitated uterine malformation
ACUM
dysmenorrhea
Authors
Weronika Zajaczkowska
Karina Kapczuk
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