Accessory Cavitated Uterine Mass: An Emerging Differential Diagnosis of Dysmenorrhea in Adolescents

Shah, Nitin; Joshi, Aditi; Bansode, Shrikant; Bansode, Vaishali

doi:10.1016/j.jmig.2020.12.021

Cited by 5 publications

(4 citation statements)

References 3 publications

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“…Intolerable pain is the most common symptom of a reproductive tract abnormality, which affects approximately 7% of young women 40 . The present case studies show that while dysmenorrhea is the most common symptom of ACUM, other pressure‐related symptoms, such as dyspareunia and dyschezia, are also possible 2,3,5,9,13,14,21,22,26,30,41–45 . Pain is typically experienced on the affected side or in the central pelvic zone, especially during the person's period.…”

Section: Clinical Presentationmentioning

confidence: 61%

“…40 The present case studies show that while dysmenorrhea is the most common symptom of ACUM, other pressure-related symptoms, such as dyspareunia and dyschezia, are also possible. 2,3,5,9,13,14,21,22,26,30,[41][42][43][44][45] Pain is typically experienced on the affected side or in the central pelvic zone, especially during the person's period. It can also occur in the days leading up to menstruation and sometimes alongside chronic pelvic pain.…”

Section: Ta B L E 1 (Continued)mentioning

confidence: 99%

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Accessory cavitated uterine malformation: Enhancing awareness about this unexplored perpetrator of dysmenorrhea

Mondal

Bhave

2023

Intl J Gynecology & Obste

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An accessory cavitated uterine mass (or malformation) (ACUM) is an isolated cystic uterine lesion located at the lateral aspect of the myometrium just below the insertion of the round ligament. Often the source of severe dysmenorrhea and pelvic pain, this condition is classified as a Müllerian abnormality. Understanding ACUMs, recognizing their clinical appearance, diagnosing an ACUM with ultrasound or magnetic resonance imaging, and advising patients about conservative, medicinal, and surgical treatment options is important to all clinicians. Although ACUM primarily presents with severe dysmenorrhea but can have other clinical symptoms, we have provided a few sample cases to help clinicians prepare for ACUM encounters. We also reviewed the other published literature available on ACUM regarding clinical presentation, etiology, and management. Last but not least, based on our research and the work of others, we offer a set of characteristics that will be useful in diagnosing and treating ACUM. ACUM diagnosis is crucial in clinically suspicious circumstances, and early treatment significantly enhances patients' quality of life.

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Section: Clinical Presentationmentioning

confidence: 61%

Section: Ta B L E 1 (Continued)mentioning

confidence: 99%

Accessory cavitated uterine malformation: Enhancing awareness about this unexplored perpetrator of dysmenorrhea

Mondal

Bhave

2023

Intl J Gynecology & Obste

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“…On reviewing the published literature, there is no doubt that the most common presentation of ACUM is dysmenorrhoea. 2,3,7,8,13,14,17,20,24,[36][37][38][39][40][41] The pain is usually felt in the ipsilateral site or the central pelvic area, especially during menstruation, and may also proceed the days before menstruation and may be accompanied by chronic pelvic pain. 2,3,8,29,36,37,41,42 Functional endometrial lining present in the accessory uterine cavity causes secretion of menstrual fluid during the period, and as the secreted fluid is placed in an enclosed space; it gets accumulated during the menstrual time, which during surgery we found as chocolate material inside the mass and chronic accumulation of this fluid leads to increased pressure within the cavity, and subsequent stretching of the cavity which produces pressure effect on the nerve fibers that are causing the pain and chronic stretched out cavity is the reason for having chronic pelvic pain.…”

Section: Clinical Presentationmentioning

confidence: 99%

Accessory cavitated uterine malformation (ACUM): A hidden face of dysmenorrhea

Mondal¹,

Bhave²

2022

IJOGR

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: Accessory cavitated uterine malformations, or mass (ACUM) is a Mullerian anomaly which increasingly recognized as a cause of severe dysmenorrhoea and pelvic pain.: To know what ACUMs are and recognize their clinical presentation, able to diagnose an ACUM using ultrasound or MRI; and counsel patients with ACUMs on the different management options, including conservative, medical, and surgery.: ACUMs are less rare than previously believed; hence ACUM diagnosis is essential in clinically suspicious cases via ultrasound and MRI, and intra-operative assessment of uterine morphology and laparoscopic surgical excision is the definitive treatment for ACUM.

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“…More recently, some investigators suggested that an accessory cavitated uterine mass (ACUM) should be considered in the differential diagnosis of dysmenorrhoea in adolescents ( Di Spiezio et al, 2015 ; Jain and Verma, 2014 ; Panwar et al, 2020 ). ACUM is a rare form of a Müllerian anomaly, that can result from gubernaculum dysfunction that may lead to persistence or duplication of paramesonephric ducts forming an accessory cavity ( Shah et al, 2021 ). This case series describes minimally invasive management of three cases of JCA.…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive management of juvenile cystic adenomyoma: report of three cases

Said¹,

Afaneh²,

Zaghmout³

et al. 2021

Facts Views Vis ObGyn

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Background: Juvenile cystic adenomyosis (JCA) represents a rare form of focal adenomyosis in young women. Objectives: To determine safety and effectiveness of minimally invasive surgery (MIS for JCA). Materials and Methods: Three patients aged 16-30 years old presented with chronic pelvic pain [2016 - 2019]. Hormonal treatment failed in two cases. Cystic lesions in the myometrium (n=2), and the broad ligament (n=1) was detected on transvaginal 2D ultrasound (TV 2D US) and/or magnetic resonance imaging (MRI). The cyst was separate from the endometrium in all the cases, within the myometrium in two patients and in the right broad ligament in one case. The cystic lesions were confirmed on laparoscopy; and laparoscopic excision of the cysts with adequate repair of the myometrial beds were performed in all cases with fertility preservation. Robotic assistance was chosen in one case in an attempt to avoid injury of the fallopian tube based on the cyst location during a previous laparoscopy. The endometrial cavity was entered in one case. Main outcome measures: Absence of intraoperative complications and relief of presenting symptoms postoperatively. Results: Pathology report confirmed the diagnosis of JCA is all cases. There were no intraoperative complications. All three patients reported relief of their symptoms 6 to 8 months after surgery. No recurrence of the JCA was reported using TV 2D US in all cases. Conclusions: MIS could be the treatment of choice for patients with JCA. The technique described in our study is safe, effective, and easy to master in experienced hands. What is new? Value of MIS in treatment of patients with JCA.

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Accessory Cavitated Uterine Mass: An Emerging Differential Diagnosis of Dysmenorrhea in Adolescents

Cited by 5 publications

References 3 publications

Accessory cavitated uterine malformation: Enhancing awareness about this unexplored perpetrator of dysmenorrhea

Accessory cavitated uterine malformation: Enhancing awareness about this unexplored perpetrator of dysmenorrhea

Accessory cavitated uterine malformation (ACUM): A hidden face of dysmenorrhea

Minimally invasive management of juvenile cystic adenomyoma: report of three cases

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