Uterus-like mass: A case report

David, C H; Burette, J.; Duminil, L.; Bonneau, S.; Janvier, Annie; Hoeffel, Christine; Birembaut, P.; Graesslin, Olivier; Raimond, Émilie

doi:10.1016/j.ejogrb.2018.12.005

Cited by 5 publications

(9 citation statements)

References 3 publications

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“…It can also occur in the days leading up to menstruation and sometimes alongside chronic pelvic pain. 2,3,8,13,14,34,41,45 The pain is caused by the accumulated secreted fluid from the functional endometrial lining inside the accessory uterine cavity, which accumulates during the menstrual cycle and presses on the nerve fibers that are responsible for feeling the cramps. Menstrual pain is a common issue, though;…”

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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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: 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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“…Various terms have been used to describe what we now call ‘ACUMs’. These include ‘juvenile cystic adenomyoma’, 4,9,13–24 ‘isolated cystic adenomyoma’, 5,10–12,25,26 ‘uterine‐like mass’, 27,28 or ‘accessory uterine cavity’ 2,29,30 . In 2010, Acién et al.…”

Section: Nomenclaturementioning

confidence: 99%

“…Severe dysmenorrhoea is the commonest presenting symptom for women with ACUMs 3,7,12,13,15,23,34,35 . The pain can be central or ipsilateral to the side of the ACUM and may be accompanied by chronic pelvic pain 1,3,8,21,28,34 . The pain is thought to be caused by an accumulation of menstrual fluid from the functioning endometrium lining the ACUM within what is an enclosed space.…”

Section: Clinical Presentationmentioning

confidence: 99%

Accessory cavitated uterine malformations (ACUMs): an unfamiliar cause of dysmenorrhoea

Setty

Naftalin

2022

The Obstetric & Gynaecologis

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Key Content Accessory cavitated uterine malformations (ACUMs) are isolated cavitated lesions within the lateral aspect of the myometrium, inferior to the attachment of the round ligament. They are a rare Müllerian anomaly and are increasingly recognised as a cause for severe dysmenorrhoea and pelvic pain. ACUMs can be diagnosed with ultrasound and magnetic resonance imaging, where they appear as well‐defined lesions with a central cavity containing haemorrhagic content, surrounded by a myometrial mantle. On histological examination, the cavity is lined by functional endometrial glands and stroma. Recognised treatments include hormonal suppression, destruction of the endometrial lining by alcohol sclerotherapy, or complete surgical excision, which has demonstrated curative results. Learning Objectives To know what ACUMs are and recognise them as a cause of dysmenorrhoea and pelvic pain. To be able to diagnose an ACUM with the use of ultrasound, MRI and histological findings if surgically excised. To be able to counsel patients with ACUMs on the different management options, including conservative, medical and surgery. Ethical issues All women with ACUMs are currently offered surgical excision, but is it appropriate to offer this, to patients as young as 13 years old, with no long‐term data on the effect of surgery on future fertility?

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“…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. However, often pain persists and increases during or even after the onset of menstruation.…”

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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Uterus-like mass: A case report

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 malformations (ACUMs): an unfamiliar cause of dysmenorrhoea

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

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